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Effect of Cervical Sagittal Balance on Laminoplasty in Patients With Cervical Myelopathy.

Research paper by Minori M Kato, Takashi T Namikawa, Akira A Matsumura, Sadahiko S Konishi, Hiroaki H Nakamura

Indexed on: 17 May '17Published on: 17 May '17Published in: Global spine journal



Abstract

Retrospective clinical study.We evaluated the relationship between cervical sagittal alignment parameters and clinical status in patients with cervical myelopathy and analyzed the effect of cervical sagittal balance on cervical laminoplasty.Patients with cervical myelopathy (n = 110) who underwent laminoplasty were included in this study. The relationship between cervical sagittal alignment parameters and clinical status was evaluated. The changes in radiographic cervical sagittal parameters and clinical status 2 years after surgery were compared between patients with preoperative C2-7 SVA ≥35 mm (group A) and those with preoperative C2-7 SVA <35 mm (group B).Preoperatively, C2-7 SVA had no correlation with defined health-related quality of life evaluation scores. At 2-year follow-up, the improvement in SF-36 physical component summary was significantly lower in group A than in group B. The postoperative change of C2-7 SVA did not significantly differ in 2 groups. Patients in group A maintained cervical regional balance after laminoplasty but experienced extensive postoperative neck pain.Our patients with a C2-7 SVA of ≥35 mm maintained cervical regional balance after laminoplasty and their improvement in myelopathy was equivalent to that in patients with a C2-7 SVA of <35 mm. However, the patents with a C2-7 SVA of ≥35 mm experienced severe postoperative neck pain. C2-7 SVA is a parameter worth considering because it can lead to poor QOL and axial neck pain after laminoplasty.