TY - JOUR
T1 - Surgical Outcomes of Selective Laminectomy for Patients With Cervical Kyphosis
T2 - A Retrospective Study of 379 Cases
AU - Ninomiya, Ken
AU - Okuyama, Kunimasa
AU - Aoyama, Ryoma
AU - Nori, Satoshi
AU - Yamane, Junichi
AU - Suzuki, Satoshi
AU - Kitamura, Kazuya
AU - Anazawa, Ukei
AU - Furukawa, Mitsuru
AU - Shiraishi, Tateru
AU - Ueda, Seiji
AU - Kato, Masahiro
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2023/9
Y1 - 2023/9
N2 - Study Design: A retrospective study. Objectives: This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs. Methods: We evaluated 379 patients with CSM after SL. The patients with kyphosis (group K) were compared with those without kyphosis (group L). Moreover, groups K and L were divided into subgroups KS and KL (SLs ≤ 2) and LS and LL (SLs ≥ 3), respectively, and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of the C2–C7 angle for satisfactory surgical outcomes, which was defined as a Japanese Orthopaedic Association (JOA) recovery rate of ≥50% in group KS. Results: The average PSS (mm) in group K was smaller than that in group L (.8 vs 1.4; P <.01), but the JOA recovery rate was comparable between the 2 groups. Meanwhile, the mean PSS and JOA recovery rate (%) in group KS was lower than those in group KL, respectively (.3 vs 1.0; P <.01, 35.1 vs 52.3; P =.047). Moreover, the average PSS of group KS (.6) was smaller than those of other subgroups (<.01). In addition, the ROC curve analysis showed that the C2–C7 angle of −14.5° could predict satisfactory surgical outcomes in group KS. Conclusion: Selective laminectomy is not contraindicated for patients with kyphosis, but a larger number of SLs may be indicated for the patients with C2–C7 angles of ≤ −14.5°.
AB - Study Design: A retrospective study. Objectives: This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs. Methods: We evaluated 379 patients with CSM after SL. The patients with kyphosis (group K) were compared with those without kyphosis (group L). Moreover, groups K and L were divided into subgroups KS and KL (SLs ≤ 2) and LS and LL (SLs ≥ 3), respectively, and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of the C2–C7 angle for satisfactory surgical outcomes, which was defined as a Japanese Orthopaedic Association (JOA) recovery rate of ≥50% in group KS. Results: The average PSS (mm) in group K was smaller than that in group L (.8 vs 1.4; P <.01), but the JOA recovery rate was comparable between the 2 groups. Meanwhile, the mean PSS and JOA recovery rate (%) in group KS was lower than those in group KL, respectively (.3 vs 1.0; P <.01, 35.1 vs 52.3; P =.047). Moreover, the average PSS of group KS (.6) was smaller than those of other subgroups (<.01). In addition, the ROC curve analysis showed that the C2–C7 angle of −14.5° could predict satisfactory surgical outcomes in group KS. Conclusion: Selective laminectomy is not contraindicated for patients with kyphosis, but a larger number of SLs may be indicated for the patients with C2–C7 angles of ≤ −14.5°.
KW - a number of laminectomies
KW - cervical kyphosis
KW - cervical spondylotic myelopathy
KW - laminoplasty
KW - posterior decompression
KW - posterior spinal cord shift
KW - selective laminectomy
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U2 - 10.1177/21925682211049799
DO - 10.1177/21925682211049799
M3 - Article
AN - SCOPUS:85118442216
SN - 2192-5682
VL - 13
SP - 1777
EP - 1786
JO - Global Spine Journal
JF - Global Spine Journal
IS - 7
ER -