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Cervical laminoplasty can improve radiculomyelopathy and cervical kyphotic alignment
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Researchers found cervical laminoplasty for ossification of the posterior longitudinal ligament can improve radiculomyelopathy in patients and increase the probability of cervical kyphotic alignment.
Researches included 50 consecutive patients who underwent cervical laminoplasty for ossification of the posterior longitudinal ligament (OPPL) and who were followed for a year. Each patient underwent a standing plain radiograph of the cervical spine, a mid-sagittal view CT and a T2-weighted sagittal view MRI preoperatively and postoperatively. Cervical spine alignment was assessed with C2-7 Cobb angle, C2-7 sagittal vertical axis and T1 slope minus C2-7 Cobb angle, researchers noted.
Patients with a C2-7 Cobb angle of less than 0° were placed in a kyphosis group. Patients with an angle of 0° to 10° were in a straight group, and patients with angles greater than 10° were in a lordosis group.
After cervical laminoplasty, researchers noted alleviation of radiculomyelopathy and, compared with the preoperative scores, improvement was seen in VAS and Japanese Orthopaedic Association (JOA) scores as well. After the procedure, 35 patients had kyphotic changes and 15 patients had lordotic changes. Researchers found cervical sagittal alignment after laminoplasty was not significantly associated with postoperative improvements in JOA scores, SF-36 scores, Neck Disability Index scores or VAS neck scores.
“[In] the current study, the postoperative change in cervical alignment (kyphotic and lordotic groups) was unrelated to clinical outcomes. When we compared the results of cervical spine alignment after laminoplasty, kyphotic alignment change was found in 70% of patients, whereas postoperative kyphosis was present in 18% of patients. Although there are a number of possible explanations for the maintenance of cervical curvature, above all else we suggest that OPLL itself can prevent postoperative kyphosis because it provides support to the spinal column,” researchers wrote in the study. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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