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Original Articles

Optimization of Paravertebral Foramen Screw Placement: A Stepwise Approach Considering O-arm Navigation Errors: Technical Note and Case Series
Yu Yamamoto, Yusuke Nishimura, Motonori Ishii, Nobuhisa Fukaya, Eisuke Tsukamoto, Ryuta Saito, Masahito Hara, Masakazu Takayasu
Neurospine 2025;22(2):514-522.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2550110.055

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Optimization of Paravertebral Foramen Screw Placement: A Stepwise Approach Considering O-arm Navigation Errors: Technical Note and Case Series
Neurospine. 2025;22(2):514-522.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2550110.055
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Optimization of Paravertebral Foramen Screw Placement: A Stepwise Approach Considering O-arm Navigation Errors: Technical Note and Case Series
Neurospine. 2025;22(2):514-522.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2550110.055
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Objective
Paravertebral foramen screws (PVFSs) have been developed for better pullout strength than lateral mass screws do and lower the risk of vertebral artery and nerve injury than do pedicle screws. While the original method involves insertion using lateral fluoroscopy, its reliability may be limited. This report is the first to assess the accuracy of PVFS insertion under navigation. Given the inherent inaccuracies associated with navigation systems, the authors propose and evaluate a novel stepwise method of inserting PVFSs, called stepwise PVFS with a focus on achieving the correct screw tip location for good cortical bone purchase.
Methods
The authors conducted a retrospective analysis of 12 patients (78 screws) who underwent cervical spine fixation with stepwise PVFS under O-arm navigation between October 2022 and February 2024. The accuracy of screw placement was evaluated using postoperative computed tomography (CT) scans.
Results
A total of 78 PVFSs were inserted in 5 men and 7 women, with an average age of 75 years (range, 52–85 years). The mean follow-up period was 471 days (range, 47–834 days). There were no adverse events related to screw insertion. Postoperative CT scans revealed that 70 screws (90%) were placed in the ideal position. Among the 8 screws that did not achieve the ideal position, 4 had lateral deviation (located in a lateral mass), whereas the other 4 were too short. There were no cases of screw loosening at the final follow-up.
Conclusion
The present study demonstrates that the stepwise PVFS method under navigation guidance achieves higher accuracy in PVFS placement compared with conventional fluoroscopy-guided PVFS, as reported in previous studies.
  • 3,681 View
  • 77 Download

Cervical Spine

Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty — A Prospective Cohort Patient-Reported Outcome Measurement Study
Chiu-Hao Hsu, Wei-Wei Chen, Meng-Yin Ho, Chin-Chieh Wu, Dar-Ming Lai
Neurospine 2024;21(4):1053-1065.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448620.310

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Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty — A Prospective Cohort Patient-Reported Outcome Measurement Study
Neurospine. 2024;21(4):1053-1065.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448620.310
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Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty — A Prospective Cohort Patient-Reported Outcome Measurement Study
Neurospine. 2024;21(4):1053-1065.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448620.310
Close
Objective
To analyze the predictive factors for neck pain and cervical spine function after laminoplasty for degenerative cervical myelopathy (DCM) using K-means for longitudinal data (KML).
Methods
In this prospective cohort study, we collected clinical and radiographic data from patients with DCM who underwent cervical laminoplasty. A novel index of surgical outcome, “neck function,” which comprises neck pain and cervical spine function according to the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire, was proposed. We treated surgical outcomes as longitudinal rather than cross-sectional data and used KML for analysis. Patients were categorized as having good or poor outcomes based on the KML graph of neck pain and cervical spine function.
Results
From 2016 to 2020, 104 patients underwent laminoplasty for DCM; however, 35 patients were excluded because of loss to follow-up or incomplete data. The authors found that central canal stenosis (odds ratio [OR], 17.93; 95% confidence interval [CI], 1.26–254.73; p=0.03) and preoperative neck pain (OR per 1 point increase=1.49; 95% CI, 1.12–1.99; p=0.006) were 2 negative predictive factors and that a positive K-line during flexion was a positive predictive factor (OR, 0.11; 95% CI, 0.01–0.87; p=0.036) for neck function after laminoplasty.
Conclusion
Central canal stenosis, preoperative neck pain and a K-line during flexion were found to be predictive of postoperative neck pain and cervical spine function after laminoplasty. To achieve better surgical outcomes for neck function, the authors suggest the utilization of these determinants as a guiding framework for the selection of surgical approaches for DCM.

Citations

Citations to this article as recorded by  Crossref logo
  • Predictive value of preoperative T1 slope minus cervical lordosis for clinical outcomes after standalone laminectomy in elderly degenerative cervical myelopathy
    Ahmed Mohammed Ragab, Mahmoud M. Taha, Mansour Abdel Mageed Makkia, Ayman M. Ismail
    Scientific Reports.2026;[Epub]     CrossRef
  • Evaluating the predictive value of K-line conversion in surgical outcomes for K-line negative cervical ossification of the posterior longitudinal ligament (OPLL): laminectomy with fusion versus laminoplasty
    San Kim, Sehan Park, Chang Ju Hwang, Jae Hwan Cho, Dong-Ho Lee
    The Spine Journal.2025; 25(12): 2620.     CrossRef
  • From the Editor-in-Chief: Featured Articles in the December 2024 Issue
    Inbo Han
    Neurospine.2024; 21(4): 1051.     CrossRef
  • A Commentary on “Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty — A Prospective Cohort Patient-Reported Outcome Measurement Study”
    Nobuyuki Shimokawa
    Neurospine.2024; 21(4): 1066.     CrossRef
  • 6,679 View
  • 177 Download
  • 4 Web of Science
  • 4 Crossref
Vertebral Body Sliding Osteotomy as a Surgical Strategy for the Treatment of Cervical Myelopathy: Complications and Pitfalls
Dong-Ho Lee, Sung Tan Cho, Sehan Park, Chang Ju Hwang, Jae Hwan Cho, Jin Hwan Kim
Neurospine 2023;20(2):669-677.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346320.160

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Vertebral Body Sliding Osteotomy as a Surgical Strategy for the Treatment of Cervical Myelopathy: Complications and Pitfalls
Neurospine. 2023;20(2):669-677.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346320.160
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Vertebral Body Sliding Osteotomy as a Surgical Strategy for the Treatment of Cervical Myelopathy: Complications and Pitfalls
Neurospine. 2023;20(2):669-677.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346320.160
Close
Objective
This retrospective cohort study has been aimed at evaluating the incidence of complications after vertebral body sliding osteotomy (VBSO) and analyzing some cases. Furthermore, the complications of VBSO were compared with those of anterior cervical corpectomy and fusion (ACCF).
Methods
This study included 154 patients who underwent VBSO (n = 109) or ACCF (n = 45) for cervical myelopathy and were followed up for > 2 years. Surgical complications, clinical and radiological outcomes were analyzed.
Results
The most common surgical complications after VBSO were dysphagia (n = 8, 7.3%) and significant subsidence (n = 6, 5.5%). There were 5 cases of C5 palsy (4.6%), followed by dysphonia (n = 4, 3.7%), implant failure (n = 3, 2.8%), pseudoarthrosis (n = 3, 2.8%), dural tears (n = 2, 1.8%), and reoperation (n = 2, 1.8%). C5 palsy and dysphagia did not require additional treatment and spontaneously resolved. The rates of reoperation (VBSO, 1.8%; ACCF, 11.1%; p = 0.02) and subsidence (VBSO, 5.5%; ACCF, 40%; p < 0.01) were significantly lower in VBSO than in ACCF. VBSO restored more C2–7 lordosis (VBSO, 13.9° ± 7.5°; ACCF, 10.1° ± 8.0°; p = 0.02) and segmental lordosis (VBSO, 15.7° ± 7.1°; ACCF, 6.6° ± 10.2°; p < 0.01) than ACCF. The clinical outcomes did not significantly differ between both groups.
Conclusion
VBSO has advantages over ACCF in terms of low rate of surgical complications related to reoperation and significant subsidence. However, dural tears may still occur despite the lessened need for ossified posterior longitudinal ligament lesion manipulation in VBSO; hence, caution is warranted.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparative efficacy and safety of ACAF, ACCF, and laminoplasty for multilevel cervical OPLL: A network meta-analysis of observational studies
    Wei Wang, Cheng-Hao Xiang, Dan Li, Xian-Zao Wang, Xin-Hua Xu
    Journal of Orthopaedic Surgery.2026;[Epub]     CrossRef
  • The number of fusion levels as a potential factor influencing long-term complications of anterior controllable antedisplacement fusion: a biomechanical analysis
    Gaole He, Haopeng Li, Liang Yan, Zhongkai Liu, Teng Lu
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Vertebral body sliding osteotomy as a less invasive alternative to 540° surgery for cervical myelopathy with rigid kyphosis
    Dong-Ho Lee, Sung Tan Cho, Chang Ju Hwang, Jae Hwan Cho, Sehan Park, Jin Hwan Kim, Wongthawat Liawrungrueang
    European Spine Journal.2026;[Epub]     CrossRef
  • Anterior Controllable Antedisplacement Fusion (ACAF) in Revision Surgery for Iatrogenic Cervical Kyphosis: Technical Note and Case Series
    Zhenlei Liu, Yaobin Wang, Lei Zhang, Shanhang Jia, He Wang, Lei Cheng, Fengzeng Jian, Kai Wang, Hao Wu
    Orthopaedic Surgery.2025; 17(4): 1265.     CrossRef
  • Novel radiologic parameter for assessing decompression adequacy in anterior cervical decompression surgery: the V-line
    Dong-Ho Lee, Sung Tan Cho, Chang Ju Hwang, Jae Hwan Cho, Sehan Park, Jin Hwan Kim, Wongthawat Liawrungrueang
    The Spine Journal.2025; 25(9): 1928.     CrossRef
  • A narrative review of surgical approaches in cervical degenerative myelopathy and update of the algorithm for decision making
    Majid Reza Farrokhi, Seyed Reza Mousavi, Abbas Khosravifarsani, Jaloliddin Mavlonov, Mohammadhadi Amir Shahpari Motlagh, Seyed Bahram Seif, Armin Akbarzadeh
    Egyptian Journal of Neurosurgery.2025;[Epub]     CrossRef
  • Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament
    Sun Woo Jang, Sang Hyub Lee, Hong Kyung Shin, Sang Ryong Jeon, Sung Woo Roh, Jin Hoon Park
    Neurospine.2023; 20(4): 1421.     CrossRef
  • 6,343 View
  • 250 Download
  • 7 Web of Science
  • 7 Crossref
Assessment of Cervical Myelopathy Risk in Ossification of the Posterior Longitudinal Ligament Patients With Spinal Cord Compression Based on Segmental Dynamic Versus Static Factors
Zhongyuan He, Nguyen Tran Canh Tung, Hiroto Makino, Taketoshi Yasuda, Shoji Seki, Kayo Suzuki, Kenta Watanabe, Hayato Futakawa, Katsuhiko Kamei, Yoshiharu Kawaguchi
Neurospine 2023;20(2):651-661.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346124.062

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Assessment of Cervical Myelopathy Risk in Ossification of the Posterior Longitudinal Ligament Patients With Spinal Cord Compression Based on Segmental Dynamic Versus Static Factors
Neurospine. 2023;20(2):651-661.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346124.062
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Assessment of Cervical Myelopathy Risk in Ossification of the Posterior Longitudinal Ligament Patients With Spinal Cord Compression Based on Segmental Dynamic Versus Static Factors
Neurospine. 2023;20(2):651-661.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346124.062
Close
Objective
Using segmental dynamic and static factors, we aimed to elucidate the pathogenesis and relationship between ossification of the posterior longitudinal ligament (OPLL) and the severity of cervical myelopathy.
Methods
Retrospective analysis of 163 OPLL patients' 815 segments. Imaging was used to evaluate each segmental space available for the spinal cord (SAC), OPLL diameter, type, bone space, K-line, the C2–7 Cobb angle, each segmental range of motion (ROM), and total ROM. Magnetic resonance imaging was used to evaluate spinal cord signal intensity. Patients were divided into the myelopathy group (M group) and the without myelopathy group (WM group).
Results
Minimal SAC (p = 0.043), (C2–7) Cobb angle (p = 0.004), total ROM (p = 0.013), and local ROM (p = 0.022) were evaluated as an independent predictor of myelopathy in OPLL. Different from the previous report, the M group had a straighter whole cervical spine (p < 0.001) and poorer cervical mobility (p < 0.001) compared to the WM group. Total ROM was not always a risk factor for myelopathy, as its impact depended on SAC, when SAC > 5 mm, the incidence rate of myelopathy decreased with the increase of total ROM. Lower cervical spine (C5–6, C6–7) showing increased “Bridge-Formation,” along with spinal canal stenosis and segmental instability (C2–3, C3–4) in the upper cervical spine, could cause myelopathy in M group (p < 0.05).
Conclusion
Cervical myelopathy is linked to the OPLL’s narrowest segment and its segmental motion. The hypermobility of the C2–3 and C3–4, contributes significantly to the development of myelopathy in OPLL.

Citations

Citations to this article as recorded by  Crossref logo
  • Changes in the Cervical Range of Motion and Clinical Outcomes After Laminectomy With Fusion for Ossification of the Posterior Longitudinal Ligament: Impact of K-Line and OPLL Subtypes
    Zhihao Ma, Yi Huang, Peihong Hou, Hao Li, Mengyuan Zhang, Jiayan Wu, Jinxu Chen, Huawei Liu, Wenhao Hu, Guoquan Zheng
    Neurosurgery.2026; 98(6): 1413.     CrossRef
  • Single-cell transcriptome profiling reveals the heterogeneity of ossification of the posterior longitudinal ligament (OPLL) and its immune microenvironment
    Zhongyuan He, Jiaxiang Zhou, Fuan Wang, Peng Guo, Jianfeng Li, Zhengya Zhu, Tao Tang, Nguyen Tran Canh Tung, Yoshiharu Kawaguchi, Shaoyu Liu, ManMan Gao, Xizhe Liu, Zhiyu Zhou
    Cell Biology and Toxicology.2026;[Epub]     CrossRef
  • Reduction of Spinal Cord Cross-Sectional Area Is Associated With Myelopathy in Severe Cervical Ossification of the Posterior Longitudinal Ligaments
    Hyun-Jun Jang, Dong-Kyu Kim, Bong-Ju Moon, Kyung-Hyun Kim, Jeong-Yoon Park, Sung-Uk Kuh, Keun-Su Kim, Yong-Eun Cho, Dong-Kyu Chin
    Neurosurgery.2026;[Epub]     CrossRef
  • Importance of gap evaluation in the ossification of posterior longitudinal ligament lesions using 3-dimensional computed tomography
    Hazem Alaa, Nguyen Tran Canh Tung, Tomoya Ueno, Hiroto Makino, Hayato Futakawa, Shoji Seki, Yoshiharu Kawaguchi
    The Spine Journal.2025; 25(1): 69.     CrossRef
  • Reduced Vertebral Hounsfield Unit Values in the Bridging Group of Ossification-Related Segments in Patients with Ossification of the Posterior Longitudinal Ligament of the Cervical Spine
    Zheming Yu, Junqiao Lv, Zhiqiang Wang, Xuefeng Tian, Xiaohua Hou, Lin Sun
    World Neurosurgery.2025; 195: 123638.     CrossRef
  • A modified measurement method for functional spinal unit ROM of cervical spine
    Jianxi Wang, Hao Zhou, Bo Hu, Fazhi Zang, Wen Yuan, Huajiang Chen, Lei Liang
    Scientific Reports.2025;[Epub]     CrossRef
  • The Role of K-Line and Canal-Occupying Ratio in Surgical Outcomes for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Retrospective Multicenter Study
    Jun Jae Shin, Sun Joon Yoo, Dong Kyu Kim, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Yong Eun Cho, Won Joo Jeong, Tae Woo Kim, Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Joongkyum Shi
    Neurospine.2025; 22(2): 337.     CrossRef
  • Factors Associated With Repeat Surgery in Cervical Ossification of the Posterior Longitudinal Ligaments
    Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Jeong Yoon Park, Dong Kyu Chin, Keun Su Kim, Yong Eun Cho
    Clinical Spine Surgery.2024; 37(4): 131.     CrossRef
  • Association between Congestive Heart Failure and Ossification of the Posterior Longitudinal Ligament in Korea: A Nationwide Longitudinal Cohort Study
    Dong Soon Jang, Hakyung Kim, Seung Hun Sheen, Inbo Han, Soo Hyun Lee, Woo Seok Choi, Je Beom Hong, Min Jai Cho, Seil Sohn
    The Nerve.2024; 10(1): 19.     CrossRef
  • Radiological and Clinical Significance of Cervical Dynamic Magnetic Resonance Imaging for Cervical Spondylotic Myelopathy
    Jun Jae Shin, Sun Joon Yoo, Tae Woo Kim, Jae-Young So, Won Joo Jeong, Mu Ha Lee, Joongkyum Shin, Yoon Ha
    Neurospine.2024; 21(2): 443.     CrossRef
  • The Improvement of Intraoperative Motor Evoked Potential after Decompression in Cervical Compressive Myelopathy: Its Significance and Related Factors
    Jong Yun Kwon, Dong Hwan Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
    The Nerve.2024; 10(2): 80.     CrossRef
  • Bone Density of Vertebral Bodies and Ossified Masses in Cervical Ossification of the Posterior Longitudinal Ligament: An Imaging Study Based on MRI, CT, and DEXA
    Mingliang Shi, Baocheng Niu, Cheng Ye, Dong Xie, Qing Chen, Qi Zhao, Hao Wu, Lili Yang
    Calcified Tissue International.2024;[Epub]     CrossRef
  • Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament
    Sun Woo Jang, Sang Hyub Lee, Hong Kyung Shin, Sang Ryong Jeon, Sung Woo Roh, Jin Hoon Park
    Neurospine.2023; 20(4): 1421.     CrossRef
  • 11,974 View
  • 223 Download
  • 11 Web of Science
  • 13 Crossref
Relationship Between Endplate Defects, Modic Change, Facet Joint Degeneration, and Disc Degeneration of Cervical Spine
Su-Hun Lee, Dong Wuk Son, Jun-Seok Lee, Soon-Ki Sung, Sang Weon Lee, Geun Sung Song
Neurospine 2020;17(2):443-452.   Published online June 30, 2020
DOI: https://doi.org/10.14245/ns.2040076.038

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Relationship Between Endplate Defects, Modic Change, Facet Joint Degeneration, and Disc Degeneration of Cervical Spine
Neurospine. 2020;17(2):443-452.   Published online June 30, 2020
DOI: https://doi.org/10.14245/ns.2040076.038
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Relationship Between Endplate Defects, Modic Change, Facet Joint Degeneration, and Disc Degeneration of Cervical Spine
Neurospine. 2020;17(2):443-452.   Published online June 30, 2020
DOI: https://doi.org/10.14245/ns.2040076.038
Close
Objective
The ‘‘disc degeneration precedes facet joint osteoarthritis’’ hypothesis and multidimensional analysis were actively discussed in lumbar spine. However, in cervical spine degeneration, the multifactorial analyzes of disc degeneration (DD), Modic changes (Mcs), facet degeneration, and endplate degeneration (ED) is still limited. In this cross-sectional study, we aimed to analyze the prevalence and interrelationship of cervical DD parameters.
Methods
We retrospectively recruited 62 patients aged between 60 and 70 years. The disc height, segmental angle, ossified posterior longitudinal ligament (OPLL), ED, facet joint degeneration (FD), uncovertebral joint degeneration (UD), DD, spinal stenosis (SS), Mc, and cord signal change (CS) were evaluated using a previously well-known grading system.
Results
The prevalence of cervical degenerative parameters were DD (grade 1, 1.2%; grade 2, 13.3%; grade 3, 54.8%; grade 4, 19.0%; grade 5, 11.7%), OPLL (26.2%), SS (grade 0, 7.7%; grade 1, 42.3%; grade 2, 26.2%; grade 3, 23.8%), UD (39.1%), ED (normal, 69.0%; focal defect, 9.7%; corner defect, 11.7%; erosion, 6.9%; sclerosis, 2.8%), and FD (normal, 48.8%; narrowing, 27.0%; hypertrophied, 24.2%). The interrelationship of degenerative parameters showed close relation between UD, SS, DD, OPLL, Mc. ED, and CS has partial relation with degenerative finding. FD only has relation with UD, and Mc.
Conclusion
Our results may indicate that FD is a degeneration that occurs independently, rather than as a result of other degenerative factors.

Citations

Citations to this article as recorded by  Crossref logo
  • Bone tunnel approach for cervical spondylotic radiculopathy with uncovertebral osteophytes
    Xin Wang, Tao Hu, Bo Lei, Chaofan Qin, Xiang Tan, Changjun Pi, Mingxin Chen, Qingshuai Yu, Si Cheng, Zhengjian Yan
    European Spine Journal.2026; 35(4): 1848.     CrossRef
  • Radiological Factors Affecting Cage Subsidence after Single-level Anterior Cervical Discectomy and Fusion with Double Titanium Cylindrical Cages
    Toshiyuki OKAZAKI, Kazuma DOI, Kazunori SHIBAMOTO, Satoshi TANI, Junichi MIZUNO
    Neurologia medico-chirurgica.2026; 66(1): 7.     CrossRef
  • Deep or Superficial? Autologous Conditioned Serum for Cervical Pain with Degenerative Disc Disease – a Randomized Controlled Trial
    Piotr Godek, Małgorzata Paprocka-Borowicz, Kuba Ptaszkowski
    Journal of Pain Research.2026; Volume 19: 1.     CrossRef
  • Does Baseline Facet Arthropathy Influence Early Clinical and Radiographic Outcomes After Cervical Disc Replacement?
    Fatima N. Anwar, James W. Nie, Vincent P. Federico, Andrea M. Roca, Srinath S. Medakkar, Alexandra C. Loya, Gregory D. Lopez, Arash J. Sayari, Kern Singh
    Neurosurgery.2025; 96(1): 87.     CrossRef
  • Lower C2 slope and milder uncovertebral joint degeneration are risk factors for pseudarthrosis after single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 102 patients with minimum 2-year follow-up
    Haoxiang Wang, Tian Xia, Ruomu Qu, Hanbo Geng, Yu Sun, Fengshan Zhang, Shengfa Pan, Xin Chen, Yanbin Zhao, Feifei Zhou
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Identification of aging-related biomarkers for intervertebral disc degeneration in whole blood samples based on bioinformatics and machine learning
    Zi-hang Li, Shi-pian Li, Ya-hao Li, Yu-cheng Wang, Zhen-yu Tang, Kai-yang Xu, Xiao-rong Li, Zhen Tan, Jiao-yi Pan, Jin-tao Liu, Hong Jiang, Zhi-jia Ma, Yu-xiang Dai, Peng-fei Yu
    Frontiers in Immunology.2025;[Epub]     CrossRef
  • Osteoporosis in adjacent cervical segments exacerbates disc herniation
    Beiyang Wang, Yang Liu, Zhiqiang Wang, Chenguang Niu, Jian Tang, Lin Sun
    Scientific Reports.2025;[Epub]     CrossRef
  • What Cervical MRI Findings Can Tell About ACDF Outcomes and Risks of ASD
    Olga Leonova, Evgenii Baykov, Aleksandr Krutko
    Clinical Spine Surgery.2025;[Epub]     CrossRef
  • Prediction of Angle Loss after L4/5 Oblique Lumbar Interbody Fusion : Development of a Risk Stratification Model
    Se-Woon Kim, Su-Hun Lee, Jun-Seok Lee, Chi-Hyung Lee, Chang-Hyun Kim, Soon-Ki Sung, Dong-Wuk Son, Sang-Weon Lee
    Journal of Korean Neurosurgical Society.2025; 68(6): 724.     CrossRef
  • Intervertebral vacuum phenomenon – prevalence and severity CT-scan analysis in patients older than 50 years: a retrospective cohort study
    Gaston Camino-Willhuber, Santiago Vildoza, Ezequiel Martinez, Lucia Canestrari, Fernando Holc, Michael Oh, Nitin Bhatia, Yu-Po Lee, Homero Bianchi, Mariana Bendersky
    Acta Radiologica.2024; 65(1): 56.     CrossRef
  • Novel Risk Factors for Cervical Facet Joint Degeneration in the Subaxial Cervical Spine: Correlation with Cervical Sagittal Alignment and Bone Mineral Density
    Yuliang Wu, Bo Sun, Zhengqi Huang, Weitao Han, Wanli Zheng, Chao Zhang, Shun Han, Shuangxing Li, Bo Gao, Wei Ye
    World Neurosurgery.2024; 185: e850.     CrossRef
  • Exploration of the correlation between facet joints cross-sectional area asymmetry and cervical disc herniation
    Weijie Yu, Xinyu Wan, Yihan Zhang, Xianlong Yue, Mengxian Jia, Minghang Chen, Jiaxin Lai, Guoting Xu, Honglin Teng
    European Spine Journal.2024; 33(8): 3008.     CrossRef
  • The Prediction of Neurological Prognosis for Cervical Spondylotic Myelopathy Using Diffusion Tensor Imaging
    Soichiro Takamiya, Motoyuki Iwasaki, Takumi Yokohama, Daisuke Oura, Yoshimasa Niiya, Miki Fujimura
    Neurospine.2023; 20(1): 248.     CrossRef
  • Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy
    Yasuhiro Takeshima, Ai Okamoto, Shohei Yokoyama, Fumihiko Nishimura, Ichiro Nakagawa, Young-Soo Park, Hiroyuki Nakase
    Neurospine.2023; 20(1): 365.     CrossRef
  • Comparative study of outcomes between allograft intervertebral disc transplantation and anterior cervical discectomy and fusion: a retrospective cohort study at least 5 years of follow-up
    Junyou Zhang, Dike Ruan, Anwu Xuan, Qing He, Chao Zhang, Cheng Xu, Chao Zhu, Qing Zhou
    European Spine Journal.2023; 32(10): 3561.     CrossRef
  • Comparing zero-profile and conventional cage and plate in anterior cervical discectomy and fusion using finite-element modeling
    Chang-Hwan Ahn, Sungwook Kang, Mingoo Cho, Seong-Hun Kim, Chi Heon Kim, Inbo Han, Chul-Hyun Kim, Sung Hyun Noh, Kyoung-Tae Kim, Jong-Moon Hwang
    Scientific Reports.2023;[Epub]     CrossRef
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    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2023; 20(3): 72.     CrossRef
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    Neurospine.2022; 19(2): 393.     CrossRef
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Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial
Tom J. O’Donohoe, Lisa Mililli, Alison Magee, Christopher Thien, Yi Yuen Wang
Neurospine 2020;17(1):174-183.   Published online March 31, 2020
DOI: https://doi.org/10.14245/ns.1938446.223

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Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial
Neurospine. 2020;17(1):174-183.   Published online March 31, 2020
DOI: https://doi.org/10.14245/ns.1938446.223
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Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial
Neurospine. 2020;17(1):174-183.   Published online March 31, 2020
DOI: https://doi.org/10.14245/ns.1938446.223
Close
Objective
To determine the effect of anterior plating on postoperative dysphagia (POD) among adult patients undergoing elective anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and determine the potential role of demographic and clinical characteristics in the development of POD.
Methods
Consecutive adults undergoing an elective, single-level, ACDF were randomly assigned to receive a stand-alone CoRoent Cage or a CoRoent Cage with a Helix, or HelixMini plate. Patients with a history of cervical spine surgery were excluded. M. D. Anderson Dysphagia Inventory and Bazaz questionnaires were completed at regular intervals for 12 months postoperatively.
Results
Twenty-five patients were recruited over a 2-year period, with 8 allocated to receive a stand-alone cage, 5 to receive a cage and Helix Mini plate, and 12 to receive a cage and Helix plate. The POD rate was 68% at 48 hours, before falling to 16% at 6 and 12 months. A longer retraction time was observed in the Helix plate group compared to the stand-alone cage group (7.88; 95% confidence interval, 0.12–15.63; p = 0.046), although there was no difference in the incidence or severity of dysphagia between cohorts at any timepoint. With the exception of body mass index, there was no difference in patients with and without dysphagia, and each of the interventions was equally efficacious with respect to clinical and radiological endpoints.
Conclusion
Dysphagia is a common consequence of ACDF and, while the placement of a large plate results in longer retraction time, it was not associated with higher rates of dysphagia. Further research is required to identify both patient-specific and surgical contributors to this complication.

Citations

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  • Outcomes of different zero-profile spacers in the treatment of two-level cervical degenerative disk disease
    Xu Xiong, Jia-Ming Liu, Wei-Wen Chen, Zi-Hao Liu, Rong-Ping Zhou, Jiang-Wei Chen, Zhi-Li Liu
    European Spine Journal.2023; 32(7): 2448.     CrossRef
  • Dysphagia as a Postoperative Complication of Anterior Cervical Discectomy and Fusion
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  • Using Swallowing Quality of Life to Compare Oropharyngeal Dysphagia Following Cervical Disc Arthroplasty or Anterior Cervical Discectomy and Fusion
    Shruthi Mohan, Caroline N Jadczak, Elliot D K Cha, Conor P Lynch, Madhav R Patel, Kevin C Jacob, Hanna Pawlowski, Michael C Prabhu, Nisheka N Vanjani, Kern Singh
    Journal of Minimally Invasive Spine Surgery and Technique.2022; 7(1): 140.     CrossRef
  • 9,005 View
  • 148 Download
  • 2 Web of Science
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Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis
William Slikker III, Alejandro A. Espinoza Orías, Grant D. Shifflett, Joe Y.B. Lee, Krzysztof Siemionow, Sapan Gandhi, Louis Fogg, Dino Samartzis, Nozomu Inoue, Howard S. An
Neurospine 2020;17(1):221-227.   Published online March 31, 2020
DOI: https://doi.org/10.14245/ns.1938440.220

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Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis
Neurospine. 2020;17(1):221-227.   Published online March 31, 2020
DOI: https://doi.org/10.14245/ns.1938440.220
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Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis
Neurospine. 2020;17(1):221-227.   Published online March 31, 2020
DOI: https://doi.org/10.14245/ns.1938440.220
Close
Objective
To identify possible radiographic predictors markers of dynamic instability including disc height (DH), disc degeneration, and spondylosis in the setting of degenerative spondylolisthesis (DS).
Methods
A retrospective review with prospectively collected data was performed on 125 patients with L4–5 DS who underwent decompression and fusion. Patients were divided into groups with dynamic instability and those without. Radiographs of the lumbar spine in neutral, flexion, and extension were used to determine degree of slip, DH, translational motion, angular motion, spondylotic changes, and lumbar lordosis. Magnetic resonance imaging (MRI) scans were reviewed to assess disc degeneration.
Results
Thirty-one percent of the patients met criteria for dynamic instability. Significant correlations (p < 0.05) were found between preserved DH and dynamic instability; increased spondylotic changes and decreased translational motion; as well as advanced MRI-based disc degeneration scores with decreased angular motion, respectively. Six radiographic parameters were utilized to create a predictive model for dynamic instability, and a receiver operating characteristic curve was able to validate the predictive model (area = 0.891, standard error = 0.034, p < 0.001).
Conclusion
In DS patients, preserved DH was significantly related to dynamic instability. This finding may represent a greater potential for slip progression over time in these patients. In contrast, disc degeneration on MRI, and spondylotic changes were inversely related to dynamic instability and may represent restabilization mechanisms that decrease the chance of future slip progression in DS.

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    Ameen Barghi, Anirudh K. Gowd, Edward Beck, Mark Glover, Christian Sangio, Hudson McKinney, Emily Barr, Marcel G. Brown, Garrett Bullock, John Birkedal, Tadhg O'Gara
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    Eric R. Zhao, Sereen Halayqeh, Troy B. Amen, Austin C. Kaidi, Zora Hahn, John E. Lama, Arsen M. Omurzakov, Tim Xu, Felipe Luis Colon, Tomoyuki Asada, Stephane Owusu-Sarpong, Quante Singleton, Farah Musharbash, Atahan Durbas, Adrian T.H. Lui, Andrea Pezzi,
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    Emilio A Reyes-Elizalde, Alejandro Antonio Reyes-Sanchez, Carla García-Ramos
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Review Articles

Recommendations of WFNS Spine Committee

Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Abdul Hafid Bajamal, Se-Hoon Kim, Mohammad Reza Arifianto, Muhammad Faris, Eko Agus Subagio, Ben Roitberg, Inyang Udo-Inyang, Jonathan Belding, Mehmet Zileli, Jutty K.B.C. Parthiban, World Federation of Neurosurgical Societies (WFNS) Spine Committee
Neurospine 2019;16(3):421-434.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938274.137

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Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Neurospine. 2019;16(3):421-434.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938274.137
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Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Neurospine. 2019;16(3):421-434.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938274.137
Close
Objective
This study was conducted to determine and recommend the most up-to-date information on the indications, complications, and outcomes of posterior surgical treatments for cervical spondylotic myelopathy (CSM) on the basis of a literature review.
Methods
A comprehensive literature search was performed, using the MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and Web of Science databases, for peer-reviewed articles published in English during the last 10 years.
Results
Posterior techniques, which include laminectomy alone, laminectomy with fusion, and laminoplasty, are often used in patients with involvement of 3 or more levels. Posterior decompression for CSM is effective for improving patients’ neurological function. Complications resulting from posterior cervical spine surgery include injury to the spinal cord and nerve roots, complications related to posterior screw fixation or instrumentation, C5 palsy, spring-back closure of lamina, and postlaminectomy kyphosis.
Conclusion
It is necessary to consider multiple factors when deciding on the appropriate operation for a particular patient. Surgeons need to tailor preoperative discussions to ensure that patients are aware of these facts. Further research is needed on the cost-to-benefit analysis of various surgical approaches, the comparative efficacy of surgical approaches using various techniques, and long-term outcomes, as current knowledge is deficient in this regard.

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Recommendations of WFNS Spine Committee

Anterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Harsh Deora, Se-Hoon Kim, Sanjay Behari, Satish Rudrappa, Vedantam Rajshekhar, Mehmet Zileli, Jutty K.B.C. Parthiban, World Federation of Neurosurgical Societies (WFNS) Spine Committee
Neurospine 2019;16(3):408-420.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938250.125

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Anterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Neurospine. 2019;16(3):408-420.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938250.125
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Anterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Neurospine. 2019;16(3):408-420.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938250.125
Close
Objective
This study was performed to review the literature and to present the most up-to-date information and recommendations on the indications, complications, and success rate of anterior surgical techniques for cervical spondylotic myelopathy (CSM). The commonly performed anterior surgical procedures are multiple-level anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion and its variants (skip corpectomy and hybrid surgery), and oblique corpectomy without fusion.
Methods
A comprehensive literature search and analysis were performed using MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and the Web of Science for peer-reviewed articles published in English during the last 10 years.
Results
Corpectomy is mandated for ventral compression of fewer than 3 vertebral segments where single-level disc and osteophyte excision is inadequate to decompress the cord. Endoscopic or oblique partial corpectomy improves the sagittal canal diameter by 67% and obviates the need for an additional bone graft procedure.
Conclusion
The indications of anterior surgery in patients with CSM include a straightened or kyphotic spine with a compression level lower than 3. With an appropriate choice of implants and meticulous surgical technique, surgical complications can be seen only rarely. Improvements after anterior surgery for CSM have been reported in 70% to 80% of patients.

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Original Articles

Cervical Spondylotic Amyotrophy: Case Series and Review of the Literature
Toshiyuki Takahashi, Junya Hanakita, Manabu Minami, Yosuke Tomita, Tomoki Sasagasako, Ryo Kanematsu
Neurospine 2019;16(3):579-588.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938210.105

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Cervical Spondylotic Amyotrophy: Case Series and Review of the Literature
Neurospine. 2019;16(3):579-588.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938210.105
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Cervical Spondylotic Amyotrophy: Case Series and Review of the Literature
Neurospine. 2019;16(3):579-588.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938210.105
Close
Objective
Cervical spondylotic amyotrophy (CSA) is a relatively rare entity caused by cervical degenerative spinal diseases and characterized by motor weakness accompanied by remarkable muscle atrophy in the upper extremities without significant sensory deficits or spastic paraparesis in the lower extremities. Postoperative outcomes and predictive prognostic factors vary among previous reports. In the present report, we describe the surgical results in patients who were surgically treated for CSA and present a literature review.
Methods
In total, 33 patients with CSA were retrospectively analyzed. Correlations between the surgical outcome and the following factors were statistically analyzed: age, sex, type of impaired muscle, preoperative severity of motor weakness, number of levels of cord or root compression, presence of a T2 high-intensity area in the spinal cord, cervical kyphosis, and methods of surgical procedure.
Results
On postoperative neurological evaluation, 25 patients (75.8%) had favorable outcomes and 8 had unfavorable outcomes (proximal type, 72.2%; distal type, 78.6%). Patients with favorable outcomes were significantly younger than those with unfavorable outcomes (p=0.013). Patient’s characteristics except for age and radiological factors were not correlated to surgical outcome.
Conclusion
The present study focused on the surgical results in patients who were surgically treated for CSA along with updated information from a literature review. Improvement of motor weakness is expected with acceptable prevalence although higher age can be a negative factor. Surgical outcomes and predictive factors related to a poor prognosis were determined and compared with those of previous articles.

Citations

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Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion
Jun Jae Shin
Neurospine 2019;16(3):589-600.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938166.083

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Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion
Neurospine. 2019;16(3):589-600.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938166.083
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Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion
Neurospine. 2019;16(3):589-600.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938166.083
Close
Objective
This study aimed to assess the influence of a fused segment on cervical range of motion (ROM) and adjacent segmental kinematics and determine whether increasing number of fusion levels causes accelerated adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF).
Methods
A total of 165 patients treated with ACDF were recruited for assessment, and they were divided into 3 groups based on the number of fusion levels. Radiological measurements and clinical outcomes included visual analogue scale (VAS) and Neck Disability Index (NDI) assessed preoperatively and at ≥2 years of follow-up.
Results
ASD occurred in 41 of 165 patients who underwent ACDF (1-level, 12 of 78 [15.38%]; 2-level, 14 of 49 [28.57%]; 3-level, 15 of 38 [39.47%]; p=0.015) at final follow-up (mean, 31.9 months). Significant differences were found in reduction of global ROM based on the number of fusion levels (p<0.001). The upper adjacent segment ROM increased over time (p=0.004); however, lower segment ROM did not. Three-level ACDF did not obtain greater amounts of lordosis than did 1- or 2-level ACDF (p=0.003). Postoperative neck VAS scores and NDI were significantly higher for 3-level ACDF than for 1- or 2-level ACDF (p=0.033 and p=0.001).
Conclusion
ASD occurred predominantly in multilevel cervical fusion, more frequently in the upper segment of the prior fusion and as the number of fusion levels increased. Patients who underwent multilevel fusion had greater reduction of global ROM and increased compensatory motion at the upper adjacent segment. Three-level ACDF did not appear to restore cervical lordosis significantly compared with 1- or 2-level arthrodesis.

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Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography
Yuki Oichi, Junya Hanakita, Toshiyuki Takahashi, Manabu Minami, Taigo Kawaoka, Yusuke Funakoshi, Takeshi Kawauchi, Yasufumi Ohtake
Neurospine 2018;15(4):388-393.   Published online September 4, 2018
DOI: https://doi.org/10.14245/ns.1836112.056

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Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography
Neurospine. 2018;15(4):388-393.   Published online September 4, 2018
DOI: https://doi.org/10.14245/ns.1836112.056
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Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography
Neurospine. 2018;15(4):388-393.   Published online September 4, 2018
DOI: https://doi.org/10.14245/ns.1836112.056
Close
Objective
Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF.
Methods
Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types).
Results
In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001).
Conclusion
On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.

Citations

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Effect of Myoarchitectonic Spinolaminoplasty on Concurrent Hypertension in Patients With Cervical Spondylotic Myelopathy
Kazushige Itoki, Ryu Kurokawa, Tetsuro Shingo, Phyo Kim
Neurospine 2018;15(1):77-85.   Published online March 28, 2018
DOI: https://doi.org/10.14245/ns.1836020.010

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Effect of Myoarchitectonic Spinolaminoplasty on Concurrent Hypertension in Patients With Cervical Spondylotic Myelopathy
Neurospine. 2018;15(1):77-85.   Published online March 28, 2018
DOI: https://doi.org/10.14245/ns.1836020.010
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Effect of Myoarchitectonic Spinolaminoplasty on Concurrent Hypertension in Patients With Cervical Spondylotic Myelopathy
Neurospine. 2018;15(1):77-85.   Published online March 28, 2018
DOI: https://doi.org/10.14245/ns.1836020.010
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Objective
When treating patients with cervical spondylotic myelopathy (CSM), we often note amelioration in concomitant hypertension after surgery. To assess the effects of surgery and the mechanisms thereof, blood pressure (BP) and parasympathetic nervous activity were monitored prospectively in CSM patients undergoing surgery.
Methods
Sixty-eight consecutive CSM patients who underwent surgery with myoarchitectonic spinolaminoplasty were enrolled. BP and electrocardiography were recorded preoperatively and at 1, 3, and 6 months postoperatively. Forty-six patients completed the scheduled follow-ups and were analyzed. Preoperatively, 17 had a mean BP higher than 100 mmHg (the HT group) and 12 had hypertension despite taking medication (the HT-refractory group). To evaluate alterations in parasympathetic function, the coefficient of variation of the RR interval (CVRR) was evaluated.
Results
A significant BP reduction was observed in the HT group 6 months after surgery, but not in the normotensive group (n=29). The effect was more remarkable in the HT-refractory group. A transient BP increase at 1 and 3 months after surgery was observed in all groups. Comparisons were made between groups classified by age (over 65 years or younger than 60 years) and the presence or absence of an intramedullary hyperintense T2 signal on magnetic resonance imaging, but no significant differences were detected. Measurements of CVRR did not significantly differ between the groups over the course of follow-up.
Conclusion
Hypertension coexisting with CSM can be ameliorated after surgical treatment. The effect is likely to be mediated by moderation of sympathetic activity, rather than parasympathetic activation. We believe that a combination of adequate decompression of the spinal cord and relief from musculoskeletal stresses effectuate this moderation.

Citations

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    Indian Journal of Anaesthesia.2022; 66(Suppl 3): S169.     CrossRef
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    Ting-Yun Chiang, Yen-Kai Wang, Wen-Cheng Huang, Shiang-Suo Huang, Ya-Chun Chu
    Frontiers in Medicine.2022;[Epub]     CrossRef
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    Medicine.2022; 101(40): e30699.     CrossRef
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    Baifeng Sun, Chen Xu, Shenshen Wu, Yizhi Zhang, Huiqiao Wu, Min Qi, Xiaolong Shen, Wen Yuan, Yang Liu
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    World Neurosurgery.2021; 155: e119.     CrossRef
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Clinical Articles

The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy
Yongjae Cho
Korean J Spine 2016;13(4):177-182.   Published online December 31, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.4.177

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The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy
Korean J Spine. 2016;13(4):177-182.   Published online December 31, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.4.177
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The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy
Korean J Spine. 2016;13(4):177-182.   Published online December 31, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.4.177
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Objective

Degenerative diseases of the spine, such as cervical spondylotic myelopathy (CSM), are increasing among the old age population, and surgical treatment of CSM is becoming more and more common. The aim of this study was to investigate how functional recovery can be influenced by anterior compression of the spinal cord (ACS) after laminoplasty for treatment of patients with CSM.

Methods

We retrospectively analyzed 32 patients admitted to Ewha Womans Mok-Dong Hospital with CSM who underwent open-door laminoplasty from January 2012 to December 2014. We divided patients into 2 groups according to whether ACS was or not preoperatively. Each group was analyzed clinical and radiological parameters which were Japanese Orthopedic Association (JOA) scores and its recovery rate, sagittal alignment and range of motion (ROM).

Results

The mean duration of symptom was 11.2 months (range, 6-22 months). A significant difference in recovery rate of the total JOA score was shown between the 2 groups, especially upper extremity motor function. No difference in preoperative JOA score between the 2 groups, but recovery rate of each group was 20.05%±18.1%, 32.21%±25.4%, statistically significant (p<0.005). Upper motor and sensory function was not significantly different in the 2 groups. Preoperative, postoperative and preservation of ROM was 44.3°±10.1°, 41.8°±15.7°, 87.9%±35.4% each at ACS (-) group. A significant difference in postoperative ROM was identified between ACS (-) and ACS (+) group. Postoperative anterior compression of the spinal cord was recognized 14 cases which were classified from its causes.

Conclusion

Cervical ROM decreased significantly after laminoplasty, but 85.3% of the preoperative ROM was preserved. The postoperative reduction of ROM in group with anterior compression of spinal cord was identified.

Citations

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  • Does Facet Joint Violation Compromise Patient-Reported Outcomes and Motion Preservation Following Cervical Laminoplasty?
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    Clinical Spine Surgery.2026; 39(4): 125.     CrossRef
  • Cervical Sagittal Imbalance after Cervical Laminoplasty in Elderly Patients
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    BioMed Research International.2020;[Epub]     CrossRef
  • Effect of osteoprotegerin gene polymorphisms on the risk of cervical spondylotic myelopathy in a Chinese population
    Hai-Ming Yu, Xiao-Lei Chen, Wu Wei, Xue-Dong Yao, Jing-Qun Sun, Xiao-Tao Su, Shu-Feng Lin
    Clinical Neurology and Neurosurgery.2018; 175: 149.     CrossRef
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Predictors of Outcome in Patients with Cervical Spondylotic Myelopathy Undergoing Unilateral Open-Door Laminoplasty
Ji-Won Shin, Sung-Won Jin, Se-Hoon Kim, Jong-Il Choi, Bum-Joon Kim, Sang-Dae Kim, Dong-Jun Lim
Korean J Spine 2015;12(4):261-266.   Published online December 31, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.4.261

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Predictors of Outcome in Patients with Cervical Spondylotic Myelopathy Undergoing Unilateral Open-Door Laminoplasty
Korean J Spine. 2015;12(4):261-266.   Published online December 31, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.4.261
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Predictors of Outcome in Patients with Cervical Spondylotic Myelopathy Undergoing Unilateral Open-Door Laminoplasty
Korean J Spine. 2015;12(4):261-266.   Published online December 31, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.4.261
Close
Objective

This study aimed to analyze prognostic factors affecting surgical outcomes of expansive laminoplasty for cervical spondylotic myelopathy (CSM).

Methods

Using the Frankel scale and Japanese Orthopaedic Association (JOA) scale, we retrospectively reviewed the outcomes of 45 consecutive patients who underwent modified unilateral open-door laminoplasty using hydroxyapatite spacers and malleable titanium miniplates between June 2008 and May 2014. The patients were assigned to the good and poor clinical outcome groups, with good outcome defined as a JOA recovery rate >75%.

Results

The mean preoperative JOA scale was significantly higher in the good outcome group (14.95±3.21 vs. 10.78±6.07, p<0.001), whereas the preoperative cervical range of motion (ROM) in this group was significantly lower (29.89°±10.11 vs. 44.35°± 8.88, p<0.001). In univariate analysis, a high preoperative JOA scale (odds ratio (OR) 1.271, 95% confidence interval (CI) 1.005-1.607) and low preoperative cervical ROM(OR 0.858, 95% CI 0.786-0.936) were statistically correlated with good outcomes. Furthermore, these factors demonstrated an independent association with clinical outcomes (preoperative JOA scale: OR 1.344, 95% CI 1.019-1.774, p=0.036; preoperative cervical ROM: OR 0.860, 95% CI 0.788-0.940, p=0.001).

Conclusion

In this study, a high preoperative JOA scale was associated with good clinical outcome after laminoplasty, whereas a higher preoperative cervical spine ROM was associated with poor clinical outcome. This may suggests that cervical mobility and preoperative neurological status affect clinical outcomes of laminoplasty.

Citations

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    Yibing Sun, Qingguo Zhang
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    Meng-Ze Zhang, Han-Qiang Ou-Yang, Jian-Fang Liu, Dan Jin, Chun-Jie Wang, Ming Ni, Xiao-Guang Liu, Ning Lang, Liang Jiang, Hui-Shu Yuan
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    Ricardo Rodrigues-Pinto, Thiago S. Montenegro, Benjamin M. Davies, So Kato, Yoshiharu Kawaguchi, Manabu Ito, Mehmet Zileli, Brian K. Kwon, Michael G. Fehlings, Paul A. Koljonen, Shekar N. Kurpad, James D. Guest, Bizhan Aarabi, Vafa Rahimi-Movaghar, Jeffer
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