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European Spine Journal

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01-05-2020 | Neck Pain | Original Article

Impact of cervical sagittal parameters and spinal cord morphology in cervical spondylotic myelopathy status post spinous process-splitting laminoplasty

Authors: Hsuan-Yu Chen, Min-Hui Yang, Yen-Po Lin, Feng-Huei Lin, Po-Quang Chen, Ming-Hsiao Hu, Shu-Hua Yang

Published in: European Spine Journal | Issue 5/2020

Abstract

Purpose

No standard strategy exists for managing cervical spondylotic myelopathy (CSM). The efficacy of spinous process-splitting laminoplasty, its impact on cervical alignment change and the incidence of postoperative neck pain remain unclear. We analyzed the parameters of cervical alignment and cord morphology in CSM.

Methods

The radiographic parameters investigated were pre- and postoperative C2–C7 lordosis (CL), C2–C7 sagittal vertical axis (CSVA), T1 slope (TS), TS minus CL (TS − CL) and cervical spinal cord morphology. Myelopathy severity was measured using two different functional scores. Statistical analysis was performed to determine significant differences between preoperative and follow-up radiological findings and change in functional scores.

Results

This retrospective study comprised 85 CSM patients from a single institute, with a minimum follow-up of 24 months. Overall, 63.5% (n = 54) of patients had improvement in their postoperative cervical lordotic alignment; 36.5% (n = 31) developed progressive aggravation of the cervical kyphotic alignment. Pearson correlation analysis showed that CSVA, TS and T1–CL were independent predictors of CL curve change. Based on the receiver operating characteristic curve, the cutoff value for CSVA was 2.89 cm with a postoperative visual analog scale (VAS) > 4. The cutoff value of the TS − CL was 20 degrees with a postoperative VAS > 4. CSVA, TS and TS − CL had a significant association with variation in CL. CSVA and TS − CL had a significant association with postoperative neck pain.

Conclusions

CSVA, T1 slope and T1–CL are good predictors of postoperative degenerative kyphotic change and neck pain. Careful consideration of their preoperative cutoff values can improve postoperative outcomes.

Level of evidence

IV.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Available only for authorised users

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Title: Impact of cervical sagittal parameters and spinal cord morphology in cervical spondylotic myelopathy status post spinous process-splitting laminoplasty
Authors: Hsuan-Yu Chen
Min-Hui Yang
Yen-Po Lin
Feng-Huei Lin
Po-Quang Chen
Ming-Hsiao Hu
Shu-Hua Yang
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keyword: Neck Pain
Published in: European Spine Journal / Issue 5/2020
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-06247-z

ACC 2024 Congress

Springer Medicine

Impact of cervical sagittal parameters and spinal cord morphology in cervical spondylotic myelopathy status post spinous process-splitting laminoplasty

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Graphic abstract

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Graphic abstract

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