title: T1 slope as a predictor of kyphotic alignment change after laminoplasty in patients with cervical myelopathy.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  To analyze the effect of T1 slope on kyphotic alignment change after cervical laminoplasty in patients with cervical myelopathy.
  
  
  BACKGROUND
  Laminoplasty is a posterior method, and maintenance of both preoperative and postoperative lordotic alignment is prerequisite for the successful surgery. Unfortunately, patients who underwent laminoplasty tend to have kyphotic alignment change after operation despite sufficient preoperative lordosis, and such kyphotic alignment change after cervical laminoplasty can reduce surgical outcome and require additional surgery.
  
  
  METHODS
  Consecutive patients who underwent cervical laminoplasty for cervical myelopathy were enrolled. Cervical spine lateral radiography in neutral, flexion, and extension were taken before surgery and at 2-year follow-up. Patients were divided into 2 groups according to the preoperative T1 slope, and postoperative cervical alignment change was compared according to the preoperative T1 slope.
  
  
  RESULTS
  A total of 51 patients were enrolled in this study. The mean age was 57.2 years (range, 39-88 yr). There were 39 male patients and 12 female patients. There were no differences in age, sex, the presence and type of ossification of posterior longitudinal ligament, and operation level between the patients with higher and lower preoperative T1 slope. Patients with higher preoperative T1 slope had more lordotic preoperative cervical alignment; however, they had more kyphotic alignment changes after laminoplasty (P < 0.001). After univariate logistic regression, only higher preoperative T1 slope was associated with significantly increased odds ratio for postoperative kyphotic alignment changes.
  
  
  CONCLUSIONS
  We hypothesized that kyphotic alignment change by posterior structural injury after cervical laminoplasty would be more marked in patients with high T1 slope, and demonstrated that patients with cervical myelopathy with high T1 slope had more kyphotic alignment changes after cervical laminoplasty at 2-year follow-up.
authors.affiliation: Spine Center, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
authors.forename: Seung Yeop
authors.initials: SY
authors.lastname: Lee
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Kim
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Park
authors.forename: Seok Woo
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging* / Q000601:surgery; D007796:Laminectomy / Q000379:methods; D016015:Logistic Models; D008141:Lordosis / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011859:Radiography / Q000379:methods; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging* / Q000601:surgery