Posterior cervical open-door expansive laminoplasty with mini-titanium plate:correlation between cervical sagittal alignment and repair effect

Gu Yong; Wang Qiang; Xin Tian-wen; Yang Hui-lin; Chen Liang

doi:10.3969/j.issn.2095-4344.2016.44.005

Abstract：BACKGROUND:Posterior cervical open-door expansive laminoplasty is one of the simple and effective methods to treat cervical spinal diseases, has satisfactory results but low complications. However, the imbalance of sagittal plan, loss of lordosis or axial pain is often reported recently. OBJECTVE:To analyze the correlation between cervical sagittal alignment and clinical outcomes after laminoplasty. METHODS:Between January 2011 and June 2015, 122 cases of cervical spinal disease, who were treated with open-door expansive laminoplasty with mini-titanium plate, were retrospectively analyzed. Clinical outcomes were evaluated by Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale. Radiographic results were assessed by C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope. The correlation between sagittal alignment and clinical outcomes were analyzed. RESULTS AND CONCLUSION:(1) Al patients were fol owed up for 7-32 months. (2) Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale scores were improved in the final fol ow-up (al P<0.001). No significant difference in upper limb Visual Analogue Scale scores was determined (P=0.142). In the final fol ow-up, C2-7 sagittal vertical axis increased (P=0.036), but neither the C2-7 Cobb angle nor the C7 slope significantly changed (P=0.092, P=0.184). (3) There were no correlations between sagittal alignment parameters (C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope) and clinical outcomes (Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale) (al P>0.05). (4) These findings indicated that posterior cervical open-door expansive laminoplasty with mini-titanium plate can significantly improve the neurological function of patients. However, there is no correlation between cervical sagittal alignment and clinical outcomes.