Journal List > J Korean Soc Spine Surg > v.19(3) > 1075984

Ahn, Lee, Lee, and Hwang: Changes in Cervical Spine Range of Motion after Laminoplasty in Cervical Spondylotic Myelopathy

Abstract

Study Design

A retrospective study.

Objectives

This study examined the cervical range of motion (ROM) of cervical spondylotic myelopathy patients, before and after open door laminoplasty.

Summary of Literature Review

Majority of the cases regarding the change of cervical range of motion after cervical laminoplasty showed decreased range of motion, and the results were diverse.

Materials and Methods

Of the 487 patients, who underwent open door laminoplasty at our hospital from March 1997 to March 2008, 98 had been followed for at least 2 years and had cervical flexion-extension lateral x-rays. In all patients, open door laminoplasty involved at least three segments: three, four, and five segments in 11, 52, and 35 patients, respectively. In previous cases, fixation involved sutures using suture anchors. The lordosis or kyphosis between C2 and C7 was analyzed using cervical flexion-extension lateral radiographs before and 2 years after the operation.

Results

The average patient age was 62.7 (range 32–82) years; 65 patients were male and 33 were female. From preoperatively to postoperatively, the average kyphosis of cervical flexion decreased from 10.7° to 7.8°, average lordosis decreased from 21.2° to 14.2°, and cervical ROM decreased from 31.9° to 22.0°, respectively (mean 9.9°, 31.0%).

Conclusions

We could observe decreased cervical range of motion after cervical laminoplasty for cervical spondylotic myelopathic patients. Thus, the treatment to prevent the postoperative decrease of cervical range of motion and further study to find a new treatment are thought to be essential.

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Fig 1.
Flexion and extension angle of the cervical spine was measured by cobb's method from bottom of C2 to bottom of C7.
jkss-19-85f1.tif
Table 1.
Mean values of flexion and extension angle.
  Preoperative angle(degree) Postoperative angle(degree) P value∗
Flexion Extension Flexion Extension
3 segments (11 cases) 18.5 28.5 12.4 21.3  
4 segments (52 cases) 10.6 21.6 8.7 15.1  
5 segments (35 cases) 8.4 18.3 4.9 10.6  
  Total (98 cases) 10.7 21.2 7.8 14.2 Flexion 0.000 Extension 0.000

P-value by paired-sample T-test

Table 2.
Mean values of change of ranges of motion(ROM) after the laminoplasty.
  Preoperative ROM (degree) Postoperative ROM (degree) Change of ROM (%) P value∗
3 segments (11 cases) 47.0 33.7 13.3(28.3%)  
4 segments (52 cases) 32.2 23.8 8.4(26.1%)  
5 segments (35 cases) 26.7 15.5 11.2(41.9%)  
  Total (98 cases) 31.9 22.0 9.9(31%) 0.000

P-value by paired-sample T-test

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