The severity of operative invasion to the posterior muscular-ligament complex influences cervical sagittal balance after open-door laminoplasty

Lin, Shio‐Jean; Zhou, Feifei; Sun, Yu; Chen, Zhongqiang; Zhang, Fengshan; Pan, Shengfa

doi:10.1007/s00586-014-3605-3

Cited by 65 publications

(48 citation statements)

References 25 publications

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“…16 Besides preoperative lordosis, loss of lordotic curvature is generally considered to be the result of posterior muscular-ligament complex disruption, especially the detachment of C2 extensor insertions during laminoplasty procedure. 13,17,18,26 In the present study, we found that plating at C3/C5 caused more LCL after laminoplasty when compared with those plated at C4/C6. Meanwhile, in the C3/C5 group, 94.1% of patients lost a certain degree of cervical lordosis and 23.5% of patients developed postoperative cervical kyphosis, both of which were significantly higher than the C4/C6 group.…”

Section: Discussionsupporting

confidence: 56%

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

Lin

Huang

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: The aim of this study is to evaluate the impact of plating level on the loss of cervical lordosis (LCL) after laminoplasty with skipped-level plating. Methods: This retrospective study included patients who underwent alternative skipped-level plating laminoplasty from C3 to C6. Patients were divided into two groups according to the plating level. Group 1 had miniplate fixed at C3 and C5 (C3/C5 group), while patients in group 2 were fixed at C4 and C6 (C4/C6 group). The outcome of interest was the difference of LCL between the two groups; meanwhile, kyphosis development after laminoplasty was also compared. Results: A total of 70 patients were included in our study with a mean age of 60.44 ± 9.97 years. The median follow-up was 15 (12, 16) months. Median lordosis was 15.43° (9.35°, 22.23°) before surgery and 9.88° (4.15°, 18.94°) after, with a median LCL of 4.48° (−0.66°, 8.11°). There were 17 patients in the C3/C5 group, whereas 53 patients in the C4/C6 group. While preoperative C2–C7 Cobb’s angle was comparable between the two groups (15.32° (9.73°, 23.84°) vs. 15.51° (9.03°, 21.70°), p = 0.864), there were statistical differences regarding postoperative C2–C7 Cobb’s angle (6.54° (2.49°, 16.42°) vs. 10.62° (5.89°, 18.85°), p = 0.006) and LCL (4.74° (4.17°, 12.03°) vs. 4.07° (−1.89°, 6.69°), p = 0.034) between the C3/C5 group and the C4/C6 group. In all, 94.1% (16 of 17) of patients showed some degree of LCL after laminoplasty in the C3/C5 group, which was significantly higher when compared with 64.2% (34 of 52) of C4/C6 group ( p = 0.038). Before surgery, there were no kyphosis patients in either the C3/C5 group or the C4/C6 group. Postoperatively, four patients (23.5%) developed kyphotic alignment in the C3/C5 group, but only one (1.9%) in the C4/C6 group ( p = 0.013). Conclusions: Cervical alignment was compromised after laminoplasty. When alternative skipped-level plating is adopted in laminoplasty from C3 to C6, plating at C4/C6 may better preserve cervical lordosis than plating at C3/C5 after surgery.

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Section: Discussionsupporting

confidence: 56%

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

Lin

Huang

et al. 2020

J Orthop Surg (Hong Kong)

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“…Many modifications such as bone grafts, hydroxyapatite or other ceramic materials, allograft and titanium plates, titanium miniplates and screws have been developed to prevent this complication (2,7,20,21,39). We have preferred titanium miniplates (Blackstone Medical Inc, USA).…”

Section: █ Resultsmentioning

confidence: 99%

Open-door laminoplasty with preservation of muscle attachments of c2 and c7 for cervical spondylotic myelopathy, retrospective study

Seçer

Harman²,

Aytar³

et al. 2017

Turkish Neurosurgery

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“…In patients with latent preoperative cervical sagittal imbalance, compensation is possible with excessive posterior muscle contraction to maintain a horizontal gaze. Therefore, damage to the posterior musculature resulting from laminoplasty may lead to decompensation, resulting in progression of cervical kyphosis [8].…”

Section: Discussionmentioning

confidence: 99%

Dropped head syndrome after cervical laminoplasty: A case control study

Koda

Furuya

Kinoshita

et al. 2016

Journal of Clinical Neuroscience

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The severity of operative invasion to the posterior muscular-ligament complex influences cervical sagittal balance after open-door laminoplasty

Abstract: Open-door laminoplasty significantly affected postoperative cervical sagittal balance, with the cervical vertebra appearing to tilt forward. As the severity of surgical invasion to the posterior muscular-ligament complex increased, the loss of cervical sagittal balance also increased.

Cited by 65 publications

References 25 publications

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

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

Open-door laminoplasty with preservation of muscle attachments of c2 and c7 for cervical spondylotic myelopathy, retrospective study

Dropped head syndrome after cervical laminoplasty: A case control study

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