Which factors predict the loss of cervical lordosis following cervical laminoplasty? A review of various indices and their clinical implications

Sharma, Ravi; Borkar, Sachin A; Goda, Revanth; Kale, Shashank S.

doi:10.25259/sni_339_2019

Cited by 11 publications

(6 citation statements)

References 18 publications

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“…In this regard, the T1 slope (T1s) has been spotlighted recently [ 31 ]. However, the influx of too many new predictive factors can cause confusion in the analysis of patients’ information [ 61 , 63 ]. In this study, we present an overview of the sagittal alignment parameters that might predict clinical or radiological results through a literature review.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty

Lee

Son

Shin

et al. 2021

J Korean Neurosurg Soc

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Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature. Preoperative kyphotic alignment was initially proposed as a predictor of clinical outcomes. The clinical significance of the K-line and K-line variants also has been studied. Sagittal vertical axis, T1 slope (T1s), T1s-cervical lordosis (CL), anterolisthesis, local kyphosis, the longitudinal distance index, and range of motion were proposed to have relationships with clinical outcomes. The relationship between loss of cervical lordosis (LCL) and T1s has been widely studied, but controversy remains. Extension function, the ratio of CL to T1s (CL/T1s), and Sharma classification were recently proposed as LCL predictors. In predicting postoperative kyphosis, T1s cannot predict postoperative kyphosis, but a low CL/ T1s ratio was associated with postoperative kyphosis.

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Section: Introductionmentioning

confidence: 99%

Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty

Lee

Son

Shin

et al. 2021

J Korean Neurosurg Soc

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“…In the present prospective study, both preoperative C2-7 angle and T1S were significantly smaller in the kyphosis group than in the lordosis group, and C1-7 SVA before surgery showed no significant difference between the 2 groups. In contrast to these results, a literature review showed that patients both with preoperative more lordotic cervical spine and high T1S are at increased risk for the loss of cervical lordosis after laminoplasty, 12 and Sakai et al 3 reported that cervical regional sagittal imbalance was a preoperative risk factor for cervical kyphotic deformity after laminoplasty for CSM in patients without preoperative cervical kyphosis. The reason why these results in this study were opposed to those in these previous reports remains unclear.…”

Section: Discussionmentioning

confidence: 94%

Postoperative Changes of Spinopelvic Sagittal Parameters after Cervical Laminoplasty for Cervical Spondylotic Myelopathy

Sakaura,

Ikegami,

Fujimori

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: A retrospective analysis of prospectively collected data. Objective: To investigate postoperative changes of spinopelvic sagittal parameters after laminoplasty for cervical spondylotic myelopathy (CSM) accompanying postoperative cervical kyphotic deformity or cervical regional sagittal imbalance. Summary of Background Data: To the best of our knowledge, no study has been reported concerning postoperative changes of spinopelvic sagittal parameters accompanying postoperative deterioration of cervical sagittal alignment or balance after cervical laminoplasty. Methods: Forty-five CSM patients without preoperative cervical kyphosis who underwent laminoplasty were included. None of the 45 patients had a medical history of previous spine surgery, hip joint surgery, or knee joint surgery. The patients were divided into 2 groups (kyphosis and lordosis groups) according to postoperative C2-7 angle, and they were also divided into 2 other groups (imbalance and balance groups) according to postoperative C1-7 sagittal vertical axis. Postoperative changes (Δ) of T1 slope (T1S), thoracic kyphosis, thoracolumbar kyphosis (TLK), lumbar lordosis (LL), Pelvic tilt, and C7 sagittal vertical axis were measured comparing lateral radiographs of the whole spine in the standing position taken at 1 year postoperatively with those before surgery. Results: Both T1S and TLK significantly decreased after cervical laminoplasty in the kyphosis group compared with the lordosis group. On the other hand, both T1S and TLK increased significantly, and LL significantly decreased after surgery in the imbalance group compared with the balance group. Conclusions: At 1 year after laminoplasty for CSM, both T1S and TLK significantly decreased accompanying postoperative cervical kyphotic deformity as a compensatory action for postoperative cervical kyphosis to maintain the global sagittal balance of the spine, whereas both T1S and TLK increased significantly, and LL significantly decreased accompanying postoperative cervical reginal sagittal imbalance which resulted in postoperative forward inclination of the whole spine.

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“…In patients undergoing cervical fusion, Sharma et al found a strong correlation between TS-CL and cSVA. They showed that the mismatch of TS-CL over 20° was associated with cSVA over 4 cm [ 35 ]. However, TS-CL cannot be obtained directly from the standard neutral lateral radiographs.…”

Section: Discussionmentioning

confidence: 99%

Relationship between C2 slope with sagittal parameters and clinical function of degenerative cervical kyphosis

Chai,

Yang,

et al. 2023

J Orthop Surg Res

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Purpose To explore the relationship between C2 slope with sagittal parameters and clinical function of degenerative cervical kyphosis (DCK). Methods A retrospective analysis of 127 patients with degenerative cervical spondylosis treated in our spinal deformity center from January 2019 to June 2022. Patients were categorized into two groups and compared based on C2-7 angle (C2-7 ≥ 5° as kyphosis group, C2-7 < 5° as lordosis group). Pearson correlation or Spearman correlation was used to analyze the relationship between C2S and conventional radiological parameters and health -related quality-of-life (HRQOL) outcomes as measured by the EuroQol 5 dimension questionnaire (EQ5D), NRS, and the neck disability index (NDI). The cutoff value of C2S was determined by a receiver operating characteristic (ROC) curve. Results There were 127 patients who met inclusion criteria (79 men and 48 women). Average 56.00 ± 10.27 years old (range 31–81 years old). C2S of kyphosis group is higher than non-kyphosis group. Aggravating cervical kyphosis increases cSVA positively. For all patients, C2S demonstrated a significant correlation with the O-C2 angle, C2-7 angle, cSVA, and TS-CL (p < 0.05). NRS, NDI and EQ5D-VAS scores revealed a significant correlation with C2S and cSVA (p < 0.01). For the subgroup of patients presenting with DCK, ROC curves demonstrated the cutoff values of C2S as 26.3°, and 30.5°, according to a cSVA of 40 mm, and severe disability expressed by NDI, respectively. Conclusion On the basis of retaining the consistency of cranio-cervical and cervico-thoracic structure, C2S can better analyze the sagittal alignment of DCK patients than TS-CL and has good practicability in clinical application and HRQOL evaluation.

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Which factors predict the loss of cervical lordosis following cervical laminoplasty? A review of various indices and their clinical implications

Cited by 11 publications

References 18 publications

Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty

Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty

Postoperative Changes of Spinopelvic Sagittal Parameters after Cervical Laminoplasty for Cervical Spondylotic Myelopathy

Relationship between C2 slope with sagittal parameters and clinical function of degenerative cervical kyphosis

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