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Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy

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Abstract

Purpose

To determine whether motion preservation following oblique cervical corpectomy (OCC) for cervical spondylotic myelopathy (CSM) persists with serial follow-up.

Methods

We included 28 patients with preoperative and at least two serial follow-up neutral and dynamic cervical spine radiographs who underwent OCC for CSM. Patients with an ossified posterior longitudinal ligament (OPLL) were excluded. Changes in sagittal curvature, segmental and whole spine range of motion (ROM) were measured. Nathan’s system graded anterior osteophyte formation. Neurological function was measured by Nurick’s grade and modified Japanese Orthopedic Association (JOA) scores.

Results

The majority (23 patients) had a single or 2-level corpectomy. The average duration of follow-up was 45 months. The Nurick’s grade and the JOA scores showed statistically significant improvements after surgery (p < 0.001). 17 % of patients with preoperative lordotic spines had a loss of lordosis at last follow-up, but with no clinical worsening. 77 % of the whole spine ROM and 62 % of segmental ROM was preserved at last follow-up. The whole spine and segmental ROM decreased by 11.2° and 10.9°, respectively (p ≤ 0.001). Patients with a greater range of segmental movement preoperatively had a statistically greater range of movement at follow-up. The analysis of serial radiographs indicated that the range of movement of the whole spine and the range of movement at the segmental spine levels significantly reduced during the follow-up period. Nathan’s grade showed increase in osteophytosis in more than two-thirds of the patients (p ≤ 0.01). The whole spine range of movement at follow-up significantly correlated with Nathan’s grade.

Conclusions

Although the OCC preserves segmental and whole spine ROM, serial measurements show a progressive decrease in ROM albeit without clinical worsening. The reduction in this ROM is probably related to degenerative ossification of spinal ligaments.

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Fig. 1

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Abbreviations

CSM:

Cervical spondylotic myelopathy

GE:

General electric

JOA:

Japanese Orthopedic Association

MRI:

Magnetic resonance imaging

OCC:

Oblique cervical corpectomy

OPLL:

Ossified posterior longitudinal ligament

PACS:

Picture archival and retrieval system

ROM:

Range of movement

VA:

Vertebral artery

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Acknowledgments

The authors would like to acknowledge Debashree Turel and Dr K. Srinivas Babu for their assistance in the artwork.

Conflict of interest

The authors report no financial support or conflict of interest.

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Authors and Affiliations

  1. Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, 632 004, Tamil Nadu, India

    Mazda K. Turel, Sauradeep Sarkar, Krishna Prabhu, Roy T. Daniel & Ari G. Chacko

  2. Department of Psychiatry, Christian Medical College, Vellore, 632 004, Tamil Nadu, India

    K. S. Jacob

Authors
  1. Mazda K. Turel
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  2. Sauradeep Sarkar
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  3. Krishna Prabhu
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  4. Roy T. Daniel
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  6. Ari G. Chacko
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Correspondence to Ari G. Chacko.

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Turel, M.K., Sarkar, S., Prabhu, K. et al. Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy. Eur Spine J 22, 1509–1516 (2013). https://doi.org/10.1007/s00586-013-2724-6

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  • DOI: https://doi.org/10.1007/s00586-013-2724-6

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