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Erschienen in: European Spine Journal 5/2020

01.05.2020 | Original Article

Impact of cervical sagittal parameters and spinal cord morphology in cervical spondylotic myelopathy status post spinous process-splitting laminoplasty

verfasst von: Hsuan-Yu Chen, Min-Hui Yang, Yen-Po Lin, Feng-Huei Lin, Po-Quang Chen, Ming-Hsiao Hu, Shu-Hua Yang

Erschienen in: European Spine Journal | Ausgabe 5/2020

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Abstract

Purpose

No standard strategy exists for managing cervical spondylotic myelopathy (CSM). The efficacy of spinous process-splitting laminoplasty, its impact on cervical alignment change and the incidence of postoperative neck pain remain unclear. We analyzed the parameters of cervical alignment and cord morphology in CSM.

Methods

The radiographic parameters investigated were pre- and postoperative C2–C7 lordosis (CL), C2–C7 sagittal vertical axis (CSVA), T1 slope (TS), TS minus CL (TS − CL) and cervical spinal cord morphology. Myelopathy severity was measured using two different functional scores. Statistical analysis was performed to determine significant differences between preoperative and follow-up radiological findings and change in functional scores.

Results

This retrospective study comprised 85 CSM patients from a single institute, with a minimum follow-up of 24 months. Overall, 63.5% (n = 54) of patients had improvement in their postoperative cervical lordotic alignment; 36.5% (n = 31) developed progressive aggravation of the cervical kyphotic alignment. Pearson correlation analysis showed that CSVA, TS and T1–CL were independent predictors of CL curve change. Based on the receiver operating characteristic curve, the cutoff value for CSVA was 2.89 cm with a postoperative visual analog scale (VAS) > 4. The cutoff value of the TS − CL was 20 degrees with a postoperative VAS > 4. CSVA, TS and TS − CL had a significant association with variation in CL. CSVA and TS − CL had a significant association with postoperative neck pain.

Conclusions

CSVA, T1 slope and T1–CL are good predictors of postoperative degenerative kyphotic change and neck pain. Careful consideration of their preoperative cutoff values can improve postoperative outcomes.

Level of evidence

IV.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.
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Metadaten
Titel
Impact of cervical sagittal parameters and spinal cord morphology in cervical spondylotic myelopathy status post spinous process-splitting laminoplasty
verfasst von
Hsuan-Yu Chen
Min-Hui Yang
Yen-Po Lin
Feng-Huei Lin
Po-Quang Chen
Ming-Hsiao Hu
Shu-Hua Yang
Publikationsdatum
01.05.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 5/2020
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-019-06247-z

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