Factors Associated With Loss of Cervical Lordosis After Laminoplasty for Patients With Cervical Ossification of the Posterior Longitudinal Ligament: Data From a Prospective Multicenter Study.

Humans Lordosis / diagnostic imaging Longitudinal Ligaments / diagnostic imaging Laminoplasty / adverse effects Prospective Studies Osteogenesis Cervical Vertebrae / diagnostic imaging Treatment Outcome Ossification of Posterior Longitudinal Ligament / diagnostic imaging Spinal Cord Diseases / surgery Retrospective Studies

Journal

Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646

Informations de publication

Date de publication:
01 Aug 2023
Historique:
received: 26 11 2022
accepted: 21 04 2023
medline: 19 7 2023
pubmed: 5 5 2023
entrez: 5 5 2023
Statut: ppublish

Résumé

A prospective multicenter study. The objective of this study was to investigate the incidence of loss of cervical lordosis after laminoplasty for cervical ossification of the posterior longitudinal ligament (OPLL). We also sought to determine associated risk factors and the relationship with patient-reported outcomes. Loss of cervical lordosis is a sequelae often observed after laminoplasty, which may adversely impact surgical outcomes. Cervical kyphosis, especially in OPLL, is associated with reoperation, but risk factors and relationship to postoperative outcomes remain understudied at this time. This study was conducted by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. We included 165 patients who underwent laminoplasty and completed Japanese Orthopaedic Association (JOA) score or Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaires (JOACMEQ), as well as Visual Analog Scales (VAS) for pain, with imaging. The participants were divided into two groups: those with loss of cervical lordosis of >10° or 20° after surgery and those without loss of cervical lordosis. A paired t test was applied to evaluate the association between changes in cervical spinal angles, range of motion, and cervical JOA and VAS scores before and at 2 years postoperatively. Mann-Whitney U test was used for JOACMEQ. Postoperative loss of cervical lordosis >10° and >20° was observed in 32 (19.4%) and 7 (4.2%), respectively. JOA, JOACMEQ, and VAS scores were not significantly different between those with, and without, loss of cervical lordosis. Preoperative small extension range of motion (eROM) was significantly associated with postoperative loss of cervical lordosis, and the cutoff values of eROM were 7.4° [area under the curve (AUC): 0.76] and 8.2° (AUC: 0.92) for loss of cervical lordosis >10° and >20°, respectively. A large occupation ratio of OPLL was also associated with loss of cervical lordosis, with a cutoff value of 39.9% (AUC: 0.94). Laminoplasty resulted in functional improvement in most patient-reported outcomes; however, neck pain and bladder function tended to become worse postoperatively in cases with postoperative loss of cervical lordosis >20°. JOA, JOACMEQ, and VAS scores were not significantly different between those with, and without, loss of cervical lordosis. Preoperative small eROM and large OPLL may represent factors associated with loss of cervical lordosis after laminoplasty in patients with OPLL.

Sections du résumé

STUDY DESIGN METHODS
A prospective multicenter study.
OBJECTIVE OBJECTIVE
The objective of this study was to investigate the incidence of loss of cervical lordosis after laminoplasty for cervical ossification of the posterior longitudinal ligament (OPLL). We also sought to determine associated risk factors and the relationship with patient-reported outcomes.
SUMMARY OF BACKGROUND DATA BACKGROUND
Loss of cervical lordosis is a sequelae often observed after laminoplasty, which may adversely impact surgical outcomes. Cervical kyphosis, especially in OPLL, is associated with reoperation, but risk factors and relationship to postoperative outcomes remain understudied at this time.
MATERIALS AND METHODS METHODS
This study was conducted by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. We included 165 patients who underwent laminoplasty and completed Japanese Orthopaedic Association (JOA) score or Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaires (JOACMEQ), as well as Visual Analog Scales (VAS) for pain, with imaging. The participants were divided into two groups: those with loss of cervical lordosis of >10° or 20° after surgery and those without loss of cervical lordosis. A paired t test was applied to evaluate the association between changes in cervical spinal angles, range of motion, and cervical JOA and VAS scores before and at 2 years postoperatively. Mann-Whitney U test was used for JOACMEQ.
RESULTS RESULTS
Postoperative loss of cervical lordosis >10° and >20° was observed in 32 (19.4%) and 7 (4.2%), respectively. JOA, JOACMEQ, and VAS scores were not significantly different between those with, and without, loss of cervical lordosis. Preoperative small extension range of motion (eROM) was significantly associated with postoperative loss of cervical lordosis, and the cutoff values of eROM were 7.4° [area under the curve (AUC): 0.76] and 8.2° (AUC: 0.92) for loss of cervical lordosis >10° and >20°, respectively. A large occupation ratio of OPLL was also associated with loss of cervical lordosis, with a cutoff value of 39.9% (AUC: 0.94). Laminoplasty resulted in functional improvement in most patient-reported outcomes; however, neck pain and bladder function tended to become worse postoperatively in cases with postoperative loss of cervical lordosis >20°.
CONCLUSIONS CONCLUSIONS
JOA, JOACMEQ, and VAS scores were not significantly different between those with, and without, loss of cervical lordosis. Preoperative small eROM and large OPLL may represent factors associated with loss of cervical lordosis after laminoplasty in patients with OPLL.

Identifiants

DOI: 10.1097/BRS.0000000000004706 PMID: 37146070
pubmed: 37146070
doi: 10.1097/BRS.0000000000004706
pii: 00007632-990000000-00343
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1047-1056

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

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Auteurs

Hiroaki Nakashima (H)

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan.
Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.

Shiro Imagama (S)

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan.
Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.

Toshitaka Yoshii (T)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Satoru Egawa (S)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Kenichiro Sakai (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchishi, Saitama Prefecture, Japan.

Kazuo Kusano (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Kudanzaka Hospital, Chiyodaku, Japan.

Shinji Tsutsui (S)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan.

Takashi Hirai (T)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Yu Matsukura (Y)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Kanichiro Wada (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori Prefecture, Japan.

Keiichi Katsumi (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Niigata University Medicine and Dental General Hospital, Niigata, Niigata Prefecture, Japan.

Masao Koda (M)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki Prefecture, Japan.

Atsushi Kimura (A)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedics, Jichi Medical University, Shimotsuke, Tochigi Prefecture, Japan.

Takeo Furuya (T)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba Prefecture, Japan.

Satoshi Maki (S)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba Prefecture, Japan.

Narihito Nagoshi (N)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Norihiro Nishida (N)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi Prefecture, Japan.

Yukitaka Nagamoto (Y)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakaishi, Osaka Prefecture, Japan.

Yasushi Oshima (Y)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Kei Ando (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Aichi Prefecture, Japan.

Masahiko Takahata (M)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido Prefecture, Japan.

Kanji Mori (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga Prefecture, Japan.

Hideaki Nakajima (H)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Fukui Prefecture, Japan.

Kazuma Murata (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan.

Masayuki Miyagi (M)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopedic Surgery, Kitasato University, School of Medicine, Sagamiharashi, Kanagawa Prefecture, Japan.

Takashi Kaito (T)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka Prefecture, Japan.

Kei Yamada (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Kurume University School of Medicine, Kyushi, Fukuoka Prefecture, Japan.

Tomohiro Banno (T)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka Prefecture, Japan.

Satoshi Kato (S)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa Prefecture, Japan.

Tetsuro Ohba (T)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, University of Yamanashi, Kofu, Yamanashi Prefecture, Japan.

Hiroshi Moridaira (H)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan.

Shunsuke Fujibayashi (S)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Hiroyuki Katoh (H)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa Prefecture, Japan.

Haruo Kanno (H)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi Prefecture, Japan.

Hiroshi Taneichi (H)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan.

Yoshiharu Kawaguchi (Y)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Toyama Prefecture, Japan.

Katsushi Takeshita (K)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedics, Jichi Medical University, Shimotsuke, Tochigi Prefecture, Japan.

Masaya Nakamura (M)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Atsushi Okawa (A)

Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Masashi Yamazaki (M)

Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa Prefecture, Japan.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Maladies ostéomusculaires › Maladies osseuses › Maladies du rachis › Déviations du rachis › Lordose › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Tissus › Tissu conjonctif › Ligaments › Ligaments articulaires › Ligaments longitudinaux › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de neurochirurgie › Laminoplastie › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système locomoteur › Développement locomoteur › Biominéralisation › Développement osseux › Ostéogenèse › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Appareil locomoteur › Squelette › Rachis › Vertèbres cervicales › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Factors Associated With Loss of Cervical...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Ossification hétérotopique › Ossification du ligament longitudinal postérieur › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Maladies de la moelle épinière › Factors Associated With Loss of Cervical...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Factors Associated With Loss of Cervical...