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Sagittal Alignment After Laminectomy Without Fusion as Treatment for Cervical Spondylotic Myelopathy: Follow-up of Minimum 4 Years Postoperatively
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Neuroorthoped Ctr, Sweden; Dept Radiol, Sweden.
Not Found:Linkoping Univ, Dept Clin and Expt Med, Linkoping, Sweden; Neuroorthoped Ctr, Sweden; Dept Radiol, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Divison of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Neuroorthoped Ctr, Sweden; Dept Radiol, Sweden.ORCID iD: 0000-0002-6928-4473
Linköping University, Department of Clinical and Experimental Medicine, Neurosurgery. Linköping University, Faculty of Health Sciences. Neuroorthoped Ctr, Sweden; Dept Radiol, Sweden.
(English)In: Global Spine Journal, ISSN 2192-5682, E-ISSN 2192-5690, article id UNSP 2192568219858302Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: The aims of this study were to evaluate the incidence of sagittal malalignment including kyphosis following cervical laminectomy without fusion as treatment for cervical spondylotic myelopathy and to assess any correlation between malalignment and clinical outcome. Study Design: Retrospective cohort study. Methods: In all, 60 patients were followed up with conventional radiography at an average of 8 years postoperatively. The cervical lordosis (C2-C7 Cobb angle), C2-C7 sagittal vertical axis (cSVA) and C7 slope were measured on both preoperative and postoperative images. Patients completed a questionnaire covering Neck Disability Index (NDI), visual analogue scale for neck pain, and general health (EQ-5D). Results: Mean C2-C7 Cobb angle was 8.6 degrees (SD 9.0) preoperatively, 3.4 degrees (10.7) postoperatively and 9.6 degrees (14.5) at follow-up. Ultimately, 3 patients showed amp;gt;20 degrees cervical kyphosis. Mean cSVA was 16.3 mm (SD 10.2) preoperatively, 20.6 mm (11.8) postoperatively, and 31.6 mm (11.8) at follow-up. Mean C7 slope was 20.4 degrees (SD 8.9) preoperatively, 18.4 degrees (9.4) postoperatively, and 32.6 degrees (10.2) at follow-up. The preoperative to follow-up increase in cSVA and C7 slope was statistically significant (both P amp;lt; .0001), but not for cervical lordosis. The preoperative to follow-up change in cSVA correlated moderately with preoperative cSVA (r = 0.43, P = .002), as did the corresponding findings regarding C7 slope (r = 0.52, P = .0001). A comparison of radiographic measurements with clinical outcome showed no strong correlations. Conclusions: No preoperative to follow-up change in cervical lordosis was found in this group; 5.0% developed amp;gt;20 degrees kyphosis. No clear correlation between sagittal alignment and clinical outcome was shown.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD. article id UNSP 2192568219858302
Keywords [en]
laminectomy; lordosis; kyphosis; cervical vertebrae; myelopathy; sagittal alignment; sagittal vertical axis; C7 slope; cervical spondylotic myelopathy; cervical spondylosis
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-159898DOI: 10.1177/2192568219858302ISI: 000479719100001OAI: oai:DiVA.org:liu-159898DiVA, id: diva2:1346126
Note

Funding Agencies|Futurum (Academy for Health and Care, Region Jonkoping County)

Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-08-27

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Löfgren, HåkanBlomqvist, AndersVavruch, Ludek
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