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European Spine Journal

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Open Access 01-07-2013 | Original Article

Long-term impacts of different posterior operations on curvature, neurological recovery and axial symptoms for multilevel cervical degenerative myelopathy

Authors: Wei Du, Linfeng Wang, Yong Shen, Yingze Zhang, Wenyuan Ding, Longxi Ren

Published in: European Spine Journal | Issue 7/2013

Abstract

Purpose

To investigate the long-term impacts of different posterior operations on curvature, neurological improvement and axial symptoms for multilevel cervical degenerative myelopathy (CDM), and to study the relationship among loss of cervical lordosis, recovery rate and axial symptom severity.

Methods

We retrospectively reviewed 98 patients with multilevel CDM who had undergone laminoplasty (Group LP, 36 patients), laminectomy (Group LC, 30 patients), or laminectomy with lateral mass screw fixation (Group LCS, 32 patients) between January 2000 and January 2005. Loss of curvature index (CI) was measured according to the preoperative and final follow-up radiographic parameters. The recovery rate was calculated based on the Japanese Orthopedic Association (JOA) score. Axial symptom severity was quantified by Neck Disability Index (NDI).

Results

Analysis of final follow-up data showed significant differences among the three groups regarding loss of CI (F = 41.46, P < 0.001) between preoperative and final follow-up JOA scores (P < 0.001), final follow-up JOA score (F = 7.81, P < 0.001), recovery rate (F = 12.98, P < 0.001) and axial symptom severity (χ ² = 18.04, P < 0.001). Loss of CI showed negative association with neurological recovery (r = −0.555, P < 0.001) and positive correlation with axial symptom severity (r = 0.696, P < 0.001).

Conclusions

Excellent neurological improvement was obtained by LP and LCS for patients with multilevel CDM, while loss of CI in groups LP and LC caused a high incidence of axial symptoms. Loss of CI was correlated with poor neurological recovery and axial symptom severity. Lateral mass screw fixation can effectively prevent loss of postoperative cervical curvature and reduce incidence of axial symptoms.

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Title: Long-term impacts of different posterior operations on curvature, neurological recovery and axial symptoms for multilevel cervical degenerative myelopathy
Authors: Wei Du
Linfeng Wang
Yong Shen
Yingze Zhang
Wenyuan Ding
Longxi Ren
Publication date: 01-07-2013
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 7/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-013-2741-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Long-term impacts of different posterior operations on curvature, neurological recovery and axial symptoms for multilevel cervical degenerative myelopathy

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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