The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty
ObjectiveCervical sagittal parameters have been widely used to predict clinical outcomes in patients with cervical spondylotic myelopathy (CSM). This study aims to coin a novel cervical sagittal parameter defined as the ratio of cervical sagittal vertical axis to T1 slope (CSVA/T1S) and to investiga...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1003757/full |
| _version_ | 1811283067552137216 |
|---|---|
| author | Dong-Fan Wang Dong-Fan Wang Wei-Guo Zhu Wei-Guo Zhu Wei Wang Wei Wang Xiang-Yu Li Xiang-Yu Li Chao Kong Chao Kong Cheng-Xin Liu Cheng-Xin Liu Bin Shi Bin Shi Shi-Bao Lu Shi-Bao Lu |
| author_facet | Dong-Fan Wang Dong-Fan Wang Wei-Guo Zhu Wei-Guo Zhu Wei Wang Wei Wang Xiang-Yu Li Xiang-Yu Li Chao Kong Chao Kong Cheng-Xin Liu Cheng-Xin Liu Bin Shi Bin Shi Shi-Bao Lu Shi-Bao Lu |
| author_sort | Dong-Fan Wang |
| collection | DOAJ |
| description | ObjectiveCervical sagittal parameters have been widely used to predict clinical outcomes in patients with cervical spondylotic myelopathy (CSM). This study aims to coin a novel cervical sagittal parameter defined as the ratio of cervical sagittal vertical axis to T1 slope (CSVA/T1S) and to investigate the correlation between CSVA/T1S and postoperative HRQOL after laminoplasty.MethodsA total of 102 CSM patients treated with cervical laminoplasty from our database were retrospectively reviewed. All patients were followed up for >12 months. Radiological parameters were measured using lateral cervical radiographs, including occiput-C2 lordosis (OC2), cervical lordosis (CL), CSVA, and T1S. Clinical parameters included the Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and JOA recovery rate. Patients were grouped by preoperative T1S, T1S-CL, and CSVA/T1S value, respectively. Clinical and radiological outcomes were compared between the groups.ResultsPatients with high CSVA/T1S had greater OC2 and CSVA but lower CL than those in the low CSVA/T1S group pre-and postoperatively. With respect to HRQOL results, the final NDI was 12.46 ± 9.11% in the low CSVA/T1S group, which was significantly lower than that in the high CSVA/T1S group (17.68 ± 8.81%, P = 0.040). Moreover, only CSVA/T1S was detected to be significantly correlated with final NDI (r = 0.310, P = 0.027). No significant correlation was found between clinical results and other cervical sagittal parameters, including T1S, CSVA, and T1S-CL.ConclusionsPreoperative CSVA/T1S was correlated with postoperative NDI in patients with CSM after cervical laminoplasty. Patients with low preoperative CSVA/T1S achieved better neurological function improvement after cervical laminoplasty. Cervical laminoplasty could be an appropriate choice for patients with lower preoperative CSVA/T1S. |
| first_indexed | 2024-04-13T02:03:54Z |
| format | Article |
| id | doaj.art-649c1063b4034fbabcb70f4a2d78fc2a |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-13T02:03:54Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-649c1063b4034fbabcb70f4a2d78fc2a2022-12-22T03:07:31ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-08-01910.3389/fsurg.2022.10037571003757The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplastyDong-Fan Wang0Dong-Fan Wang1Wei-Guo Zhu2Wei-Guo Zhu3Wei Wang4Wei Wang5Xiang-Yu Li6Xiang-Yu Li7Chao Kong8Chao Kong9Cheng-Xin Liu10Cheng-Xin Liu11Bin Shi12Bin Shi13Shi-Bao Lu14Shi-Bao Lu15Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, ChinaObjectiveCervical sagittal parameters have been widely used to predict clinical outcomes in patients with cervical spondylotic myelopathy (CSM). This study aims to coin a novel cervical sagittal parameter defined as the ratio of cervical sagittal vertical axis to T1 slope (CSVA/T1S) and to investigate the correlation between CSVA/T1S and postoperative HRQOL after laminoplasty.MethodsA total of 102 CSM patients treated with cervical laminoplasty from our database were retrospectively reviewed. All patients were followed up for >12 months. Radiological parameters were measured using lateral cervical radiographs, including occiput-C2 lordosis (OC2), cervical lordosis (CL), CSVA, and T1S. Clinical parameters included the Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and JOA recovery rate. Patients were grouped by preoperative T1S, T1S-CL, and CSVA/T1S value, respectively. Clinical and radiological outcomes were compared between the groups.ResultsPatients with high CSVA/T1S had greater OC2 and CSVA but lower CL than those in the low CSVA/T1S group pre-and postoperatively. With respect to HRQOL results, the final NDI was 12.46 ± 9.11% in the low CSVA/T1S group, which was significantly lower than that in the high CSVA/T1S group (17.68 ± 8.81%, P = 0.040). Moreover, only CSVA/T1S was detected to be significantly correlated with final NDI (r = 0.310, P = 0.027). No significant correlation was found between clinical results and other cervical sagittal parameters, including T1S, CSVA, and T1S-CL.ConclusionsPreoperative CSVA/T1S was correlated with postoperative NDI in patients with CSM after cervical laminoplasty. Patients with low preoperative CSVA/T1S achieved better neurological function improvement after cervical laminoplasty. Cervical laminoplasty could be an appropriate choice for patients with lower preoperative CSVA/T1S.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1003757/fullcervical sagittal vertical axist1 slopecervical laminoplastyclinical outcomessagittal alignment |
| spellingShingle | Dong-Fan Wang Dong-Fan Wang Wei-Guo Zhu Wei-Guo Zhu Wei Wang Wei Wang Xiang-Yu Li Xiang-Yu Li Chao Kong Chao Kong Cheng-Xin Liu Cheng-Xin Liu Bin Shi Bin Shi Shi-Bao Lu Shi-Bao Lu The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty Frontiers in Surgery cervical sagittal vertical axis t1 slope cervical laminoplasty clinical outcomes sagittal alignment |
| title | The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty |
| title_full | The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty |
| title_fullStr | The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty |
| title_full_unstemmed | The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty |
| title_short | The discrepancy between preoperative cervical sagittal vertical axis and T1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty |
| title_sort | discrepancy between preoperative cervical sagittal vertical axis and t1 slope predisposes inferior clinical outcomes in patients with cervical spondylotic myelopathy after cervical laminoplasty |
| topic | cervical sagittal vertical axis t1 slope cervical laminoplasty clinical outcomes sagittal alignment |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1003757/full |
| work_keys_str_mv | AT dongfanwang thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT dongfanwang thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiguozhu thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiguozhu thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiwang thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiwang thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT xiangyuli thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT xiangyuli thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chaokong thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chaokong thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chengxinliu thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chengxinliu thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT binshi thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT binshi thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT shibaolu thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT shibaolu thediscrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT dongfanwang discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT dongfanwang discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiguozhu discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiguozhu discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiwang discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT weiwang discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT xiangyuli discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT xiangyuli discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chaokong discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chaokong discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chengxinliu discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT chengxinliu discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT binshi discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT binshi discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT shibaolu discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty AT shibaolu discrepancybetweenpreoperativecervicalsagittalverticalaxisandt1slopepredisposesinferiorclinicaloutcomesinpatientswithcervicalspondyloticmyelopathyaftercervicallaminoplasty |