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Importance of the preoperative cross-sectional area of the semispinalis cervicis as a risk factor for loss of lordosis after laminoplasty in patients with cervical spondylotic myelopathy

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Abstract

Purpose

To investigate the effect of the preoperative cross-sectional area (CSA) of the semispinalis cervicis on postoperative loss of cervical lordosis (LCL) after laminoplasty.

Methods

A total of 144 patients who met the inclusion criteria between January 1999 and December 2015 were enrolled. Radiographic assessments were performed to evaluate the T1 slope, C2-7 sagittal vertical axis (SVA), cephalad vertebral level undergoing laminoplasty (CVLL), preoperative C2-7 Cobb angle, and preoperative CSA of the semispinalis cervicis.

Results

The T1 slope and the summation of the CSAs (SCSA) at each level of the semispinalis cervicis correlated with LCL, whereas the C2-7 SVA, CVLL, and preoperative C2-7 Cobb angle did not. Multiple regression analysis demonstrated that a high T1 slope and a low SCSA of the semispinalis cervicis were associated with LCL after laminoplasty in patients with cervical spondylotic myelopathy (CSM). The CSA of the semispinalis cervicis at the C6 level had the greatest association with LCL, which suddenly decreased with a LCL of 10°. The best cutoff point of the CSA of the semispinalis cervicis at the C6 level, which predicts LCL > 10°, was 154.5 mm2 (sensitivity 74.3%; specificity 71.6%; area under the curve 0.828; 95% confidence interval 0.761–0.895).

Conclusion

Preoperative SCSA of the semispinalis cervicis was a risk factor for LCL after laminoplasty. Spine surgeons should evaluate semispinalis cervicis muscularity at the C6 level when planning laminoplasty for patients with CSM.

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Authors and Affiliations

  1. Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 gil, Songpa-gu, Seoul, 05505, Korea

    Byung-Jou Lee, Jin Hoon Park, Sang-Ryong Jeon, Seung-Chul Rhim & Sung Woo Roh

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  1. Byung-Jou Lee
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  2. Jin Hoon Park
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Correspondence to Jin Hoon Park or Sung Woo Roh.

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The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Ethical approval

This study was approved by the Institutional Review Board of the Asan Medical Center (IRB#: 2017-1120).

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Lee, BJ., Park, J.H., Jeon, SR. et al. Importance of the preoperative cross-sectional area of the semispinalis cervicis as a risk factor for loss of lordosis after laminoplasty in patients with cervical spondylotic myelopathy. Eur Spine J 27, 2720–2728 (2018). https://doi.org/10.1007/s00586-018-5726-6

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  • DOI: https://doi.org/10.1007/s00586-018-5726-6

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