title: Postoperative changes of spinal curvature and range of motion in adult patients with cervical spinal cord tumors: analysis of 51 cases and review of the literature.
abstract: OBJECTIVE
  We sought to determine factors likely to influence postoperative changes in cervical spinal curvature and range of motion (ROM) in patients with cervical spinal cord tumors.
  
  
  METHODS
  Fifty-one patients who underwent tumor excision via a single posterior approach were examined. Surgical methods were classified as follows: group A, expansive open-door laminoplasty (ELAP); group B, conventional laminectomy; and group C, hemilaminectomy (HL). Pre- and postoperative cervical spinal curvature, cervical curvature type, and ROM were evaluated using lateral radiographs.
  
  
  RESULTS
  Worsening of cervical curvature type was statistically less frequent in group C than in group A or B (P < 0.05), although no significant difference was evident overall between pre- and postoperative cervical curvature indexes or ROM in any group. Cases of C2 surgery showed more frequent curvature worsening (80%) in group A than in other groups (P < 0.05). Postoperative changes of the cervical curvature in patients with cervical spinal cord tumors were greatly influenced by the surgical method; the cervical curvature was particularly unfavorable when patients had C2 decompression.
  
  
  CONCLUSIONS
  Careful attention to postoperative changes in the spinal curvature is needed when ELAP is performed, especially if surgery involves C2. HL is the best posterior approach for resection of cervical spinal cord tumors from the viewpoint of postoperative spinal curvature and ROM.
authors.affiliation: Department of Orthopaedic Surgery, National Defense Medical College, Saitama, Japan. asayan@me.ndmc.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Asazuma
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakamura
authors.forename: Mario
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Chibo
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Toyama
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology; D016059:Range of Motion, Articular; D013120:Spinal Cord Neoplasms / Q000601:surgery*