title: Postoperative cervical kyphosis after atlantoaxial fixation and cervical expansive laminoplasty at one time.
abstract: Cervical kyphotic deformity is one of the well-known complications after atlantoaxial fixation or cervical expansive laminoplasty, but to our knowledge there is no information about postoperative cervical kyphosis after performing these operations simultaneously. The aims of this study were to evaluate the changes in the cervical alignment after simultaneous atlantoaxial fixation and cervical expansive laminoplasty, and to discuss the risk factors of this deformity. Five patients (1 man and 4 women) who underwent the simultaneous procedure were examined. Their mean age at surgery was 68.4+/-3.4 years, and the mean follow-up period was 30.8+/-9.5 months. Their underlying diseases were rheumatoid arthritis, and one of them had athetosis, too. On neutral lateral cervical radiographs, tangents were drawn to the inferior endplates of C2 to C5, respectively, and we measured the angles between C2 and C3, C3 and C4, C4 and C5, and C2 and C5 just after surgery and at the latest follow-up. The mean angles were 2.1, -1.9, 1.8, and 1.2 degrees, respectively, just after surgery; and 2.1, -3.5, -2.6, and -5.8 degrees, respectively, at the latest follow-up. Although the mean angle between C2 and 3 hardly changed postoperatively, the mean angle between C2 and C5 significantly decreased postoperatively. In summary, atlantoaxial fixation and cervical expansive laminoplasty may be an unsuitable combination because cervical kyphosis after the simultaneous procedure developed as a complication during the short-term follow-up.
authors.affiliation: The Department of Orthopaedic Surgery, Hikone Municipal Hospital, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Hosoe
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Hori
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nishimoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Kodama
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D001268:Atlanto-Axial Joint / Q000601:surgery*; D001672:Biocompatible Materials / Q000008:administration & dosage; D002574:Cervical Vertebrae; D017886:Durapatite / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000009:adverse effects*
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite