Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty

Abstract Objective To analyze the correlation between the changes in cervical curvature and the sagittal parameters of spino-pelvic and clinical efficacy after posterior laminoplasty (LP). Methods The patients with cervical spondylosis treated with LP from June 2018 to December 2020 were reviewed. T...

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Main Authors: Xiang-Yu Li, Yu Wang, Wei-Guo Zhu, Chao Kong, Shi-Bao Lu
Format: Article
Language:English
Published: BMC 2022-12-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-022-03421-w
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author Xiang-Yu Li
Yu Wang
Wei-Guo Zhu
Chao Kong
Shi-Bao Lu
author_facet Xiang-Yu Li
Yu Wang
Wei-Guo Zhu
Chao Kong
Shi-Bao Lu
author_sort Xiang-Yu Li
collection DOAJ
description Abstract Objective To analyze the correlation between the changes in cervical curvature and the sagittal parameters of spino-pelvic and clinical efficacy after posterior laminoplasty (LP). Methods The patients with cervical spondylosis treated with LP from June 2018 to December 2020 were reviewed. The preoperative and follow-up spine full-length films were measured. The measured data included C2–C7 Cobb angle, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), pelvic incidence, sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), and C7-SVA. Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) score were recorded before surgery and follow-up. Results There were 56 patients in this study. There were no significant differences in spino-pelvic sagittal parameters before and after surgery; however, the JOA score significantly improved. The changes in postoperative cervical lordosis correlated with SS, PT, LL, T1S, and C7-SVA (P < 0.05). Regression analysis showed that T1S and C7-SVA were associated with reducing cervical lordosis (P = 0.021 and P = 0.001, respectively). Patients with larger T1S combined with larger C7-SVA had more cervical lordosis loss, poor JOA improvement, and high postoperative NDI scores (P < 0.001, P = 0.018, and P < 0.001, respectively). Conclusion Patients should be examined with full-length spine film before surgery to evaluate the cervical and spino-pelvic sagittal balance. T1S and C7-SVA correlated with changes in cervical sagittal alignment after LP. Level of evidence III.
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spelling doaj.art-d5665ec948c04629bcce5cfc6b8110332022-12-22T04:37:48ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-12-011711910.1186/s13018-022-03421-wImpact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplastyXiang-Yu Li0Yu Wang1Wei-Guo Zhu2Chao Kong3Shi-Bao Lu4Department of Orthopedics, Xuanwu Hospital, Capital Medical UniversityDepartment of Orthopedics, Xuanwu Hospital, Capital Medical UniversityDepartment of Orthopedics, Xuanwu Hospital, Capital Medical UniversityDepartment of Orthopedics, Xuanwu Hospital, Capital Medical UniversityDepartment of Orthopedics, Xuanwu Hospital, Capital Medical UniversityAbstract Objective To analyze the correlation between the changes in cervical curvature and the sagittal parameters of spino-pelvic and clinical efficacy after posterior laminoplasty (LP). Methods The patients with cervical spondylosis treated with LP from June 2018 to December 2020 were reviewed. The preoperative and follow-up spine full-length films were measured. The measured data included C2–C7 Cobb angle, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), pelvic incidence, sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), and C7-SVA. Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) score were recorded before surgery and follow-up. Results There were 56 patients in this study. There were no significant differences in spino-pelvic sagittal parameters before and after surgery; however, the JOA score significantly improved. The changes in postoperative cervical lordosis correlated with SS, PT, LL, T1S, and C7-SVA (P < 0.05). Regression analysis showed that T1S and C7-SVA were associated with reducing cervical lordosis (P = 0.021 and P = 0.001, respectively). Patients with larger T1S combined with larger C7-SVA had more cervical lordosis loss, poor JOA improvement, and high postoperative NDI scores (P < 0.001, P = 0.018, and P < 0.001, respectively). Conclusion Patients should be examined with full-length spine film before surgery to evaluate the cervical and spino-pelvic sagittal balance. T1S and C7-SVA correlated with changes in cervical sagittal alignment after LP. Level of evidence III.https://doi.org/10.1186/s13018-022-03421-wSpino-pelvic sagittal balanceCervical sagittal alignmentLaminoplasty
spellingShingle Xiang-Yu Li
Yu Wang
Wei-Guo Zhu
Chao Kong
Shi-Bao Lu
Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
Journal of Orthopaedic Surgery and Research
Spino-pelvic sagittal balance
Cervical sagittal alignment
Laminoplasty
title Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
title_full Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
title_fullStr Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
title_full_unstemmed Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
title_short Impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
title_sort impact of cervical and global spine sagittal alignment on cervical curvature changes after posterior cervical laminoplasty
topic Spino-pelvic sagittal balance
Cervical sagittal alignment
Laminoplasty
url https://doi.org/10.1186/s13018-022-03421-w
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