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- Title
Risk Factors for Cervical Deformity After Posterior Cervical Decompression Surgery: A Multicenter Study.
- Authors
Oe, Shin; Kurosu, Kenta; Hasegawa, Tomohiko; Shimizu, Satoshi; Yoshida, Go; Fujita, Tomotada; Kobayashi, Sho; Yamada, Tomohiro; Ide, Koichiro; Nakai, Keiichi; Yotsuya, Kumiko; Yamato, Yu; Yasuda, Tatsuya; Banno, Tomohiro; Arima, Hideyuki; Mihara, Yuki; Ushirozako, Hiroki; Watanabe, Yuh; Matsuyama, Yukihiro
- Abstract
Study Design: Retrospective multicenter study. Objective: Posterior decompression surgery for cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) is a common surgery; however, it can cause postoperative cervical deformity (CD). The purpose of this study was to investigate the risk factors for CD. Methods: The participants were 193 patients underwent laminoplasty or laminectomy for CSM or OPLL. CD was defined as a C2-7 sagittal vertical axis (SVA) ≥ 40 mm or a cervical lordosis angle (CL) ≤ −10°. The participants were divided into 2 groups: NCD (without CD before surgery), CD (with CD before surgery). NCD group was divided based on the presence of CD 1 year after surgery as follows: postoperative CD (PCD) and no PCD (NPCD). Results: There were 153 patients (NCD), 40 (CD), 126 (NPCD), and 27 (PCD). There was significant difference in the number of decompressed lamina (NPCD: PCD = 4.1:4.5), the presence of C2 decompression (2: 11%), and C5 palsy (0: 11%). The risk factors for onset of CD, PCD, and CL ≤ −10° as assessed by multiple logistic regression analysis were preoperative C2-7 SVA ≥ 30 mm (odds ratio [OR]: 19.0), decompression of C2 or C7 lamina (OR 3.1), and preoperative CL ≤ 2° (OR 42.0), respectively. Conclusions: To prevent postoperative CD, it is important to avoid decompression of the C2 or C7 lamina. Moreover, in case with C2-7 SVA ≥ 30 mm or CL ≤ 2° before surgery, it is important to explain the risks and consider adding fusion surgery.
- Subjects
SPINAL surgery; SURGICAL decompression; LAMINECTOMY; CERVICAL spondylotic myelopathy; MULTIPLE regression analysis; LOGISTIC regression analysis
- Publication
Global Spine Journal, 2023, Vol 13, Issue 6, p1457
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/21925682211036660