The impact of plating level on the postoperative loss of cervical lordosis in alternative skipped-level plating laminoplasty

Wu, Jing; Lin, Junyu; Huang, Zucheng; Wu, Xiaoliang

doi:10.1177/2309499019896882

Cited by 2 publications

(1 citation statement)

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“…One study compared laminoplasty starting at either C3 or C4 and reported significantly less loss of lordosis in the C4 group [34]. When using skip-level plating, another group reported improved postoperative lordosis when plating at C4 and C6 rather than C3 and C5 [35]. Finally, another group reported good clinical outcomes using partial undercutting ("dome") laminectomy at C3 above C4 laminoplasty instead of C3 laminoplasty, but their study did not include a comparison group [36].…”

Section: Introductionmentioning

confidence: 99%

Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?

Macki,

Chryssikos,

Meade

et al. 2023

JCM

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Introduction: In a multilevel cervical laminoplasty operation for patients with cervical spondylotic myelopathy (CSM), a partial or complete C3 laminectomy may be performed at the upper level instead of a C3 plated laminoplasty. It is unknown whether C3 technique above the laminoplasty affects loss of cervical lordosis or range of motion. Methods: Patients undergoing multilevel laminoplasty of the cervical spine (C3–C6/C7) at a single institution were retrospectively reviewed. Patients were divided into two cohorts based on surgical technique at C3: C3–C6/C7 plated laminoplasty (“C3 laminoplasty only”, N = 61), C3 partial or complete laminectomy, plus C4–C6/C7 plated laminoplasty (N = 39). All patients had at least 1-year postoperative X-ray treatment. Results: Of 100 total patients, C3 laminoplasty and C3 laminectomy were equivalent in all demographic data, except for age (66.4 vs. 59.4 years, p = 0.012). None of the preoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (13.1° vs. 11.1°, p = 0.259), T1 slope (32.9° vs. 29.2°, p = 0.072), T1 slope–cervical lordosis (19.8° vs. 18.6°, p = 0.485), or cervical sagittal vertical axis (3.1 cm vs. 2.7 cm, p = 0.193). None of the postoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (9.4° vs. 11.2°, p = 0.369), T1 slope–cervical lordosis (21.7° vs. 18.1°, p = 0.126), to cervical sagittal vertical axis (3.3 cm vs. 3.6 cm, p = 0.479). In the total cohort, 31% had loss of cervical lordosis >5°. Loss of lordosis reached 5–10° (mild change) in 13% of patients and >10° (moderate change) in 18% of patients. C3 laminoplasty and C3 laminectomy cohorts did not differ with respect to no change (<5°: 65.6% vs. 74.3%, respectively), mild change (5–10°: 14.8% vs. 10.3%), and moderate change (>10°: 19.7% vs. 15.4%) in cervical lordosis, p = 0.644. When controlling for age, ordinal regression showed that surgical technique at C3 did not increase the odds of postoperative loss of cervical lordosis. C3 laminectomy versus C3 laminoplasty did not differ in the postoperative range of motion on cervical flexion–extension X-rays (23.9° vs. 21.7°, p = 0.451, N = 91). Conclusion: There was no difference in postoperative loss of cervical lordosis or postoperative range of motion in patients who underwent either C3–C6/C7 plated laminoplasty or C3 laminectomy plus C4–C6/C7 plated laminoplasty.

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Section: Introductionmentioning

confidence: 99%