Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters
Abstract Background For patients with spinal canal stenosis in the upper cervical spine who undergo C3–7 laminoplasty alone, it remains impossible to achieve full decompression due to its limited range. This study explores the extension of expansive open-door laminoplasty (EODL) to C1 and C2 for the...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-020-3083-1 |
| _version_ | 1818661798463668224 |
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| author | Wen-xuan Wang Yi-bo Zhao Xiang-dong Lu Xiao-feng Zhao Yuan-zhang Jin Xian-wei Chen Yan-xin Fan Xiao-nan Wang Run-tian Zhou Bin Zhao |
| author_facet | Wen-xuan Wang Yi-bo Zhao Xiang-dong Lu Xiao-feng Zhao Yuan-zhang Jin Xian-wei Chen Yan-xin Fan Xiao-nan Wang Run-tian Zhou Bin Zhao |
| author_sort | Wen-xuan Wang |
| collection | DOAJ |
| description | Abstract Background For patients with spinal canal stenosis in the upper cervical spine who undergo C3–7 laminoplasty alone, it remains impossible to achieve full decompression due to its limited range. This study explores the extension of expansive open-door laminoplasty (EODL) to C1 and C2 for the treatment of cervical spinal stenosis of the upper cervical spine and its effects on cervical sagittal parameters. Methods A retrospective analysis of 33 patients presenting with symptoms of cervical spondylosis myelopathy (CSM) and ossification in the posterior longitudinal ligament (OPLL) of the upper cervical spine from February 2013 to December 2015 was performed. Furthermore, the changes in the C0–2 Cobb angle, C1–2 Cobb angle, C2–7 Cobb angle, C2–7 SVA, and T1-Slope in lateral X-rays of the cervical spine were measured before, immediately after, and 1 year after the operation. JOA and NDI scores were used to evaluate spinal cord function. Results The C0–2 and C1–2 Cobb angles did not significantly increase (P = 0.190 and P = 0.081), but the C2–7 Cobb angle (P = 0.001), C2–7 SVA (P < 0.001), and T1-Slope (P < 0.001) significantly increased from preoperative to 1 year postoperative. In addition, C2–7 SVA was significantly correlated with the T1-Slope (Pearson = 0.376, P < 0.001) and C0–2 Cobb angle (Pearson = 0.287, P = 0.004), and the C2–7 SVA was negatively correlated with the C2–7 Cobb angle (Pearson = − 0.295, P < 0.001). The average preoperative and postoperative JOA scores were 8.3 ± 1.6 and 14.6 ± 1.4 points, respectively, indicating in a postoperative neurological improvement rate of approximately 91.6%. The average preoperative and final follow-up NDI scores were 12.62 ± 2.34 and 7.61 ± 1.23. Conclusions The sagittal parameters of patients who underwent EODL extended to C1 and C2 included loss of cervical curvature, increased cervical anteversion and compensatory posterior extension of the upper cervical spine to maintain visual balance in the field of vision. However, the changes in cervical spine parameters were far less substantial than the alarm thresholds reported in previous studies. We believe that EODL extended to C1 and C2 for the treatment of patients with spinal canal stenosis in the upper cervical spine is a feasible and safe procedure with excellent outcomes. |
| first_indexed | 2024-12-17T04:50:47Z |
| format | Article |
| id | doaj.art-3904e9b2b40f424e837f098bed8bacd3 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-17T04:50:47Z |
| publishDate | 2020-02-01 |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3904e9b2b40f424e837f098bed8bacd32022-12-21T22:02:55ZengBMCBMC Musculoskeletal Disorders1471-24742020-02-0121111010.1186/s12891-020-3083-1Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parametersWen-xuan Wang0Yi-bo Zhao1Xiang-dong Lu2Xiao-feng Zhao3Yuan-zhang Jin4Xian-wei Chen5Yan-xin Fan6Xiao-nan Wang7Run-tian Zhou8Bin Zhao9Department of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopaedics, The Second Hospital of Shanxi Medical UniversityAbstract Background For patients with spinal canal stenosis in the upper cervical spine who undergo C3–7 laminoplasty alone, it remains impossible to achieve full decompression due to its limited range. This study explores the extension of expansive open-door laminoplasty (EODL) to C1 and C2 for the treatment of cervical spinal stenosis of the upper cervical spine and its effects on cervical sagittal parameters. Methods A retrospective analysis of 33 patients presenting with symptoms of cervical spondylosis myelopathy (CSM) and ossification in the posterior longitudinal ligament (OPLL) of the upper cervical spine from February 2013 to December 2015 was performed. Furthermore, the changes in the C0–2 Cobb angle, C1–2 Cobb angle, C2–7 Cobb angle, C2–7 SVA, and T1-Slope in lateral X-rays of the cervical spine were measured before, immediately after, and 1 year after the operation. JOA and NDI scores were used to evaluate spinal cord function. Results The C0–2 and C1–2 Cobb angles did not significantly increase (P = 0.190 and P = 0.081), but the C2–7 Cobb angle (P = 0.001), C2–7 SVA (P < 0.001), and T1-Slope (P < 0.001) significantly increased from preoperative to 1 year postoperative. In addition, C2–7 SVA was significantly correlated with the T1-Slope (Pearson = 0.376, P < 0.001) and C0–2 Cobb angle (Pearson = 0.287, P = 0.004), and the C2–7 SVA was negatively correlated with the C2–7 Cobb angle (Pearson = − 0.295, P < 0.001). The average preoperative and postoperative JOA scores were 8.3 ± 1.6 and 14.6 ± 1.4 points, respectively, indicating in a postoperative neurological improvement rate of approximately 91.6%. The average preoperative and final follow-up NDI scores were 12.62 ± 2.34 and 7.61 ± 1.23. Conclusions The sagittal parameters of patients who underwent EODL extended to C1 and C2 included loss of cervical curvature, increased cervical anteversion and compensatory posterior extension of the upper cervical spine to maintain visual balance in the field of vision. However, the changes in cervical spine parameters were far less substantial than the alarm thresholds reported in previous studies. We believe that EODL extended to C1 and C2 for the treatment of patients with spinal canal stenosis in the upper cervical spine is a feasible and safe procedure with excellent outcomes.https://doi.org/10.1186/s12891-020-3083-1Upper cervical spineMuscular-ligament complexExpansive open-door laminoplastyCervical sagittal parameters |
| spellingShingle | Wen-xuan Wang Yi-bo Zhao Xiang-dong Lu Xiao-feng Zhao Yuan-zhang Jin Xian-wei Chen Yan-xin Fan Xiao-nan Wang Run-tian Zhou Bin Zhao Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters BMC Musculoskeletal Disorders Upper cervical spine Muscular-ligament complex Expansive open-door laminoplasty Cervical sagittal parameters |
| title | Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters |
| title_full | Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters |
| title_fullStr | Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters |
| title_full_unstemmed | Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters |
| title_short | Influence of extending expansive open-door laminoplasty to C1 and C2 on cervical sagittal parameters |
| title_sort | influence of extending expansive open door laminoplasty to c1 and c2 on cervical sagittal parameters |
| topic | Upper cervical spine Muscular-ligament complex Expansive open-door laminoplasty Cervical sagittal parameters |
| url | https://doi.org/10.1186/s12891-020-3083-1 |
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