title: Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature.
abstract: METHODS
  A large-scale analysis of radiographical results of patients with cervical spondylotic myelopathy and a review of the literature.
  
  
  OBJECTIVE
  To identify changes in sagittal alignment and range of motion (ROM) after cervical laminoplasty.
  
  
  BACKGROUND
  Cervical laminoplasty is an effective procedure for decompressing multilevel spinal cord compression. It often induces postoperative complications such as loss of lordotic alignment and restriction of neck motion. Although numerous studies have reported the loss of flexion-extension ROM after laminoplasty, no large-scale study has been reported.
  
  
  METHODS
  Five hundred twenty consecutive patients with cervical spondylotic myelopathy (331 male and 189 female; mean age, 62.2 yr) who underwent modified double-door laminoplasty were enrolled. The average follow-up period was 33.3 months. All patients were allowed to sit up and walk on the first postoperative day using an orthosis, which could be removed within the first 2 weeks, even if long. Early cervical ROM exercises were performed as a part of the rehabilitation schedule. Radiography was performed before surgery and at the final follow-up. Cervical alignment in the neutral and flexion-extension view were measured by the Cobb method at C2-C7. The ROM was assessed by measuring the difference in alignment between flexion and extension.
  
  
  RESULTS
  The mean C2-C7 alignment in the neutral position was 11.9° lordotic preoperatively and 13.6° lordotic postoperatively; the alignment increased by 1.8° in lordosis. The mean total ROM decreased from a preoperative value of 40.1° to 33.5° at the final follow-up, showing a significant difference of 6.6°. The mean total ROM preservation after laminoplasty was 87.9%.
  
  
  CONCLUSIONS
  Sagittal alignment was slightly changed, with only a 1.8° increase in lordosis. The ROM of the cervical spine was preserved by 87.9%. This preservation of alignment and ROM might be attributable to improvements including early removal of the cervical orthosis, postoperative neck exercises, and some surgical modifications.
authors: Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Nagoya, Japan. masaaki_machino_5445_2@yahoo.co.jp
authors: Masaaki
authors: M
authors: Machino
authors: Yasutsugu
authors: Y
authors: Yukawa
authors: Tetsuro
authors: T
authors: Hida
authors: Keigo
authors: K
authors: Ito
authors: Hiroaki
authors: H
authors: Nakashima
authors: Shunsuke
authors: S
authors: Kanbara
authors: Daigo
authors: D
authors: Morita
authors: Fumihiko
authors: F
authors: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D013118:Spinal Cord Diseases / Q000503:physiopathology* / Q000601:surgery; D055009:Spondylosis / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult