Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Dec 3;97(2):320-331.
doi: 10.1227/neu.0000000000003299.

Comparative Analysis of Outcomes and Kyphotic Risk Factors After Cervical Laminoplasty in 2 Different Ossification of the Posterior Longitudinal Ligament Groups and Cervical Spondylotic Myelopathy

Hyun Woong Mun  1 , Jong Joo Lee  1 , Hyun Chul Shin  1 , Tae-Hwan Kim  2 , Seok Woo Kim  2 , Jae Keun Oh  1
Affiliations
Comparative Study

Comparative Analysis of Outcomes and Kyphotic Risk Factors After Cervical Laminoplasty in 2 Different Ossification of the Posterior Longitudinal Ligament Groups and Cervical Spondylotic Myelopathy

Hyun Woong Mun et al. Neurosurgery. .

Abstract

Background and objectives: Cervical laminoplasty is commonly used to treat cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL). Postoperative kyphotic changes can restrict spinal cord dorsal shift, leading to poor neurological outcomes. This study analyzes risk factors for loss of cervical lordosis (LCL) after laminoplasty in 3 groups: CSM, continuous OPLL, and other OPLL. It also evaluates postoperative changes in cervical spine parameters: C2-7 sagittal vertical axis, C2-7 Cobb angle (CA), T1 slope, and C2 slope.

Methods: This retrospective study included 154 patients who underwent cervical laminoplasty from January 2018 to January 2023. Patients were categorized into 3 groups: CSM (Group 1), continuous OPLL group (Group 2), and noncontinuous OPLL group (Group 3). Preoperative and postoperative radiographic parameters were measured. Analysis of variance and Tukey HSD post hoc tests identified significant differences among the groups. Receiver operating characteristic analysis determined the cutoff value of K-line tilt.

Results: Kyphotic changes (>10°) were observed in 18.2% of patients postoperatively: 23.8% in Group 1, 1.7% in Group 2, and 28.3% in Group 3. Significant differences were found among the groups in preoperative K-line, C2-7 CA, extension C2-7 CA, and C2 slope ( P < .05). Univariate and multivariate analyses revealed that greater age, higher K-line tilt, lower preoperative CA-extensor CA, and lower extensor muscle volume were significant risk factors of LCL in Groups 1 and 3. In Group 2, higher preoperative K-line tilt and K-line negative status were associated with greater LCL. Receiver operating characteristic analysis showed that K-line tilt is a strong predictive parameter with a threshold of 15.15°.

Conclusion: The continuous OPLL group had a lower likelihood of postoperative kyphosis due to structural support. K-line tilt, dynamic extension reserve, and extensor muscle volume were significant predictors of LCL in CSM and segmental OPLL groups. K-line tilt is a valuable radiographic parameter for predicting outcomes and guiding surgical decisions in cervical laminoplasty patients.

Keywords: Cervical laminoplasty; Cervical lordosis; Cervical spondylotic myelopathy; K-line tilt; Kyphosis; Ossification of the posterior longitudinal ligament.

PubMed Disclaimer

References

    1. Shimokawa N, Sato H, Matsumoto H, Takami T. Review of radiological parameters, imaging characteristics, and their effect on optimal treatment approaches and surgical outcomes for cervical ossification of the posterior longitudinal ligament. Neurospine. 2019;16(3):506-516.
    1. Head J, Rymarczuk G, Stricsek G, et al. Ossification of the posterior longitudinal ligament: surgical approaches and associated complications. Neurospine. 2019;16(3):517-529.
    1. Seichi A, Takeshita K, Ohishi I, et al. Long-term results of double-door laminoplasty for cervical stenotic myelopathy. Spine. 2001;26(5):479-487.
    1. Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine. 1983;8(7):693-699.
    1. Pettersson SD, Skrzypkowska P, Ali S, et al. Predictors for cervical kyphotic deformity following laminoplasty: a systematic review and meta-analysis. J Neurosurg Spine. 2023;38(1):4-13.

Publication types

MeSH terms