Effects of posterior single open-door laminoplasty and anterior cervical corpectomy fusion on cervical sagittal balance parameters in the treatment of multilevel cervical spondylotic myelopathy

doi:10.12307/2022.183

Abstract

Abstract: BACKGROUND: Posterior single open-door laminoplasty (LAMP) and anterior cervical corpectomy fusion (ACCF) can effectively treat cervical spondylotic myelopathy. However, the two treatments have different effects on the postoperative cervical spine sagittal balance.
OBJECTIVE: To compare the effects of LAMP and ACCF on cervical sagittal balance parameters in the treatment of multilevel cervical spondylotic myelopathy.
METHODS: Seventy patients with multilevel cervical spondylotic myelopathy in First Affiliated Hospital of Bengbu Medical College from August 2017 to August 2020 were enrolled in this study. There were 40 cases in ACCF group and 30 cases in LAMP group. Lateral cervical X-ray films were taken before operation and during follow-up. C2-7 Cobb angle, C2-7 sagittal vertical axis, and T1 inclination angle were compared between the two groups. This study was approved by the Ethics Committee of First Affiliated Hospital of Bengbu Medical College.
RESULTS AND CONCLUSION: (1) Compared with preoperatively, there was no significant change in the T1 inclination angle between the two groups at 10 months after surgery (P > 0.05). There was no significant difference between the two groups in the T1 inclination angle at the 10-month postoperative period (P > 0.05). (2) Compared with preoperatively, the C2-7 Cobb angle of patients in the ACCF group increased at 10 months after surgery (P < 0.05), and the C2-7 Cobb angle of patients in the LAMP group decreased at 10 months after surgery (P < 0.05). The C2-7 Cobb angle of patients in the ACCF group was greater than that of the LAMP group at 10 months after surgery (P < 0.05). (3) Compared with preoperatively, C2-7 sagittal vertical axis in the ACCF group decreased at 10 months after the operation (P < 0.05), and C2-7 sagittal vertical axis increased in the LAMP group at 10 months after the operation (P < 0.05). The C2-7 sagittal vertical axis of the ACCF group was smaller than that of the LAMP group at 10 months after surgery (P < 0.05). (4) In the ACCF group, the postoperative C2-7 Cobb angle and C2-7 sagittal vertical axis changes in patients with high T1 inclination angle were not significantly different from those in patients with low T1 inclination angle (P > 0.05). In the LAMP group, the changes of C2-7 Cobb angle and C2-7 sagittal vertical axis in patients with high T1 inclination angle were greater than those in patients with low T1 inclination angle (P < 0.05). (5) The findings showed that compared with LAMP, ACCF in the treatment of multilevel cervical spondylotic myelopathy can avoid cervical kyphosis, better maintain the physiological curvature of the cervical spine and improve the sagittal balance of the cervical spine. To avoid postoperative sagittal balance decompensation of cervical vertebra, ACCF is more suitable than LAMP for the treatment of cervical spondylotic myelopathy with high T1 inclination angle.

Key words: implant, cervical spine, cervical spondylosis, cervical spine surgery, sagittal balance, spinal fusion, spinal canal stenosis

CLC Number:

Li Jian, Bao Zhengqi, Zhou Pinghui, Zhu Ruizhi, Li Zhixiang, Wang Jinzi. Effects of posterior single open-door laminoplasty and anterior cervical corpectomy fusion on cervical sagittal balance parameters in the treatment of multilevel cervical spondylotic myelopathy[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(6): 949-953.

Figures/Tables 6

References

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