Surgical Outcomes of Selective Laminectomy for Patients With Cervical Kyphosis: A Retrospective Study of 379 Cases

Ken Ninomiya, Kunimasa Okuyama, Ryoma Aoyama, Satoshi Nori, Junichi Yamane, Satoshi Suzuki, Kazuya Kitamura, Ukei Anazawa, Mitsuru Furukawa, Tateru Shiraishi, Seiji Ueda, Masahiro Kato

Research output: Contribution to journalArticlepeer-review

Abstract

Study Design: A retrospective study. Objectives: This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs. Methods: We evaluated 379 patients with CSM after SL. The patients with kyphosis (group K) were compared with those without kyphosis (group L). Moreover, groups K and L were divided into subgroups KS and KL (SLs ≤ 2) and LS and LL (SLs ≥ 3), respectively, and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of the C2–C7 angle for satisfactory surgical outcomes, which was defined as a Japanese Orthopaedic Association (JOA) recovery rate of ≥50% in group KS. Results: The average PSS (mm) in group K was smaller than that in group L (.8 vs 1.4; P <.01), but the JOA recovery rate was comparable between the 2 groups. Meanwhile, the mean PSS and JOA recovery rate (%) in group KS was lower than those in group KL, respectively (.3 vs 1.0; P <.01, 35.1 vs 52.3; P =.047). Moreover, the average PSS of group KS (.6) was smaller than those of other subgroups (<.01). In addition, the ROC curve analysis showed that the C2–C7 angle of −14.5° could predict satisfactory surgical outcomes in group KS. Conclusion: Selective laminectomy is not contraindicated for patients with kyphosis, but a larger number of SLs may be indicated for the patients with C2–C7 angles of ≤ −14.5°.

Original languageEnglish
JournalGlobal Spine Journal
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • a number of laminectomies
  • cervical kyphosis
  • cervical spondylotic myelopathy
  • laminoplasty
  • posterior decompression
  • posterior spinal cord shift
  • selective laminectomy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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