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Predictors of cervical lordosis loss after laminoplasty in patients with cervical spondylotic myelopathy

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Abstract

Purpose

To determine whether radiological, clinical, and demographic findings in patients with cervical spondylotic myelopathy (CSM) were independently associated with loss of cervical lordosis (LCL) after laminoplasty.

Methods

The prospective study included 41 consecutive patients who underwent laminoplasty for CSM. The difference in C2-7 Cobb angle between the postoperative and preoperative films was used to evaluate change in cervical alignment. Age, sex, body mass index (BMI), smoking history, preoperative C2-7 Cobb angle, T1 slope, C2-7 range of motion (C2-7 ROM), C2-7 sagittal vertical axis (C2-7 SVA), and cephalad vertebral level undergoing laminoplasty (CVLL) were assessed. Data were analyzed using Pearson and Spearman correlation test, and univariate and stepwise multivariate linear regression.

Results

T1 slope, C2-7 SVA, and CVLL significantly correlated with LCL (P < 0.001), whereas age, BMI, and preoperative C2-7 Cobb angle did not. In multiple linear regression analysis, higher T1 slope (B = 0.351, P = 0.037), greater C2-7 SVA (B = 0.393, P < 0.001), and starting laminoplasty at C4 level (B = − 7.038, P < 0.001) were significantly associated with higher postoperative LCL.

Conclusions

Cervical alignment was compromised after laminoplasty in patients with CSM, and the degree of LCL was associated with preoperative T1 slope, C2-7 SVA, and CVLL.

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Acknowledgements

We thank Dr. Jie Li for his assistance in the statistical analysis.

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Authors and Affiliations

  1. Department of Spinal Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Jing Tao Zhang, Jia Qi Li, Rui Jie Niu, Zhao Liu, Tong Tong & Yong Shen

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  1. Jing Tao Zhang
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  2. Jia Qi Li
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  3. Rui Jie Niu
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  4. Zhao Liu
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  5. Tong Tong
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Correspondence to Yong Shen.

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Zhang, J.T., Li, J.Q., Niu, R.J. et al. Predictors of cervical lordosis loss after laminoplasty in patients with cervical spondylotic myelopathy. Eur Spine J 26, 1205–1210 (2017). https://doi.org/10.1007/s00586-017-4971-4

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  • DOI: https://doi.org/10.1007/s00586-017-4971-4

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