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Factors that regulate spinal cord position after expansive open-door laminoplasty

  • Original Article • SPINE - CERVICAL
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Although appropriate dorsal migration of the spinal cord is a desired end point of cervical laminoplasty, it is difficult to predict in advance the spinal cord position after surgery and to control it during surgery. The aim of the present study was to investigate the factors that affect postoperative spinal cord position after cervical laminoplasty using multivariable analysis.

Materials and methods

We retrospectively assessed 56 consecutive patients with cervical spondylotic myelopathy treated by open-door laminoplasty. The postoperative anterior space of the spinal cord was measured at 204 levels, and its maximum value was measured at 56 levels within the decompressed area. To identify the factors that regulate the postoperative spinal cord position, we evaluated seven radiological parameters, including the C3–C7 lordosis angle (LA), LA of the decompressed area, C3–C7 spinal cord lordosis angle (SCLA), SCLA of the decompressed area, spinal canal sagittal diameter at C5, number of expanded lamina, and postoperative dural sac diameter.

Results

The postoperative anterior space of the spinal cord was 5.5 ± 1.4 mm, and its maximum value was 6.4 ± 1.3 mm. A multiple linear regression analysis revealed that the number of expanded laminae (standardized partial regression coefficient: β = 0.17, p = 0.009) and dural sac diameter (β = 0.43, p < 0.001) was significantly associated with anterior space of the spinal cord. Although these parameters were also significantly associated with the maximum value, their relative contributions were reversed; β = 0.49 (p < 0.001) for the number of expanded laminae and 0.25 (p = 0.029) for the dural sac diameter.

Conclusions

The number of expanded laminae and dural sac diameter was significantly associated with the spinal cord position after laminoplasty. These factors could help to predict spinal cord position following laminoplasty and achieve adequate indirect decompression of the spinal cord.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Takashi Tsuji, Kazuhiro Chiba, Takashi Asazuma, Hideaki Imabayashi & Naobumi Hosogane

  2. Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan

    Takashi Tsuji & Morio Matsumoto

  3. Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, 160-8582, Japan

    Takashi Tsuji

Authors
  1. Takashi Tsuji
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  2. Kazuhiro Chiba
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  3. Takashi Asazuma
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  4. Hideaki Imabayashi
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  5. Naobumi Hosogane
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  6. Morio Matsumoto
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Corresponding author

Correspondence to Takashi Tsuji.

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Conflict of interest

Dr. Tsuji reports personal fees from consultancy and personal fees from speaker’s bureaus, outside the submitted work. Dr. Chiba reports personal fees from consultancy, personal fees from speaker’s bureaus, and personal fees from payment for manuscript preparation and educational presentation, outside the submitted work. Dr. Asazuma has nothing to disclose. Dr. Imabayashi has nothing to disclose. Dr. Hosogane has nothing to disclose. Dr. Matsumoto reports personal fees from consultancy and personal fees from speaker’s bureaus, outside the submitted work.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This retrospective clinical study was approved by the institutional review board (No. 967). For this type of study, formal consent is not required.

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Tsuji, T., Chiba, K., Asazuma, T. et al. Factors that regulate spinal cord position after expansive open-door laminoplasty. Eur J Orthop Surg Traumatol 27, 93–99 (2017). https://doi.org/10.1007/s00590-016-1847-y

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  • DOI: https://doi.org/10.1007/s00590-016-1847-y

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