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Effect of posterior cervical expansive open-door laminoplasty on cervical sagittal balance

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Abstract

Purpose

Posterior cervical expansive open-door laminoplasty (LAMP) is a mature surgical procedure for the treatment of cervical spondylotic myelopathy (CSM), but there are few studies on the changes in cervical sagittal balance. This study aimed to analyze the imaging and clinical data of patients who underwent LAMP and to explore the effect of this procedure on the cervical sagittal balance.

Methods

This was a retrospective study of the patients who underwent LAMP between 01/2014 and 12/2017. The C0–C2 Cobb angle, sagittal vertical angle (SVA), C2–C7 Cobb angle, and T1-slope were measured. The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and visual analog scale (VAS) were used.

Results

There were 69 males and 39 females. The mean age was 61.3 ± 5.3 years. The C0–C2 Cobb angle increased from 11.3 ± 5.5° to 26.8 ± 4.8° (P = 0.186). The C2–C7 Cobb angle decreased from 13.9 ± 8.6° to 10.65 ± 10.7° P = 0.016). SVA increased from 21.0 ± 5.8 mm to 25.4 ± 11.5 mm (P = 0.001). The preoperative average JOA score was 11.1 ± 2.2 points, and the postoperative score was 14.0 ± 2.1 points, with an average improvement rate of JOA of 46.5 ± 3.8%. The NDI score decreased from preoperative 15.6 ± 5.4 points to 11.3 ± 7.9 points, and the VAS score was decreased from 4.6 ± 1.8 points to 3.3 ± 1.6 points (all P < 0.05).

Conclusion

LAMP improved the neurological function and quality of life of patients with CSM. The cervical vertebrae show a tendency of tilting forward, suggesting that overextension of the upper cervical vertebra might be used to maintain the center of gravity of the skull and horizontal vision.

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Acknowledgments

The authors thank Professor Xun Ma, Professor Haoyu Feng, and Chief Physician Chen Chen for their academic support. The authors also thank Dr. Zhiyong Qin and Dr. Yi Huang for assisting in the recording of follow-up data and the measurement of imaging data of patients.

Funding

This work has no funding support.

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Authors and Affiliations

  1. Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Bethune Hospital Affiliated to Shanxi Medical University, Taiyuan, 030032, Shanxi, China

    Yubo Pan, Xun Ma, Haoyu Feng, Chen Chen, Zhiyong Qin & Yi Huang

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  1. Yubo Pan
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Correspondence to Yubo Pan or Xun Ma.

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This study was approved by the ethics committee of Shanxi Da Hospital.

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Pan, Y., Ma, X., Feng, H. et al. Effect of posterior cervical expansive open-door laminoplasty on cervical sagittal balance. Eur Spine J 29, 2831–2837 (2020). https://doi.org/10.1007/s00586-020-06563-9

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