Influence of the Ratio of C2-C7 Cobb angle to T1 Slope on the Cervical Alignment After Laminoplasty.

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Influence of the Ratio of C2-C7 Cobb angle to T1 Slope on the Cervical Alignment After Laminoplasty.

World Neurosurg. 2019 Jan 14;:

Authors: Li XY, Kong C, Sun XY, Lu SB, Guo MC, Ding JZ, Yang YM

Abstract
PURPOSE: To assess the relationship between the ratio of C2-C7 Cobb angle to T1 slope (CL/T1S) and cervical alignment changes after laminoplasty.
METHODS: 78 consecutive patients with cervical myelopathy who underwent laminoplasty were enrolled. All patients with preoperative and follow-up cervical spine lateral x-ray images available for review were recruited in this study. Imaging data included C2-C7 Cobb angle, T1 slope, cervical sagittal vertical axis (cSVA). All patients were classified into low ratio group (bottom 25% of CL/T1S), fair ratio group (middle 50% of CL/T1S), and high ratio group (top 25% of CL/T1S) according to CL/T1S ratio. The recovery rate was calculated based on the Japanese orthopedic Association score.
RESULTS: The preoperative C2-C7 Cobb angle had significant correlations with the T1 slope (r=0.528). Kyphotic alignment changes in the group with high ratio of CL/T1S was greater than that of the other two groups (p < 0.001). The incidence of postoperative kyphosis in the group with low ratio of CL/T1S was higher than that of the other two groups (p < 0.001). There was no postoperative kyphosis in the fair ratio group. The surgical outcome in low CL/T1S ratio group and high CL/T1S ratio group was poorer than that in fair CL/T1S ratio group (p = 0.005).
CONCLUSIONS: The cervical alignment was kept well in mid-range CL/T1S ratio group after laminoplasty. Patients with a high CL/T1S ratio were more likely to present with kyphotic alignment change. Patients with a low CL/T1S ratio were more likely to exhibit postoperative kyphosis.

PMID: 30654159 [PubMed - as supplied by publisher]

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