Analysis of Preoperative Factors Affecting Postoperative Spinal Canal Expansion after Posterior Decompression for the Treatment of Multilevel Cervical Myelopathy (다발성 경추 척수증의 치료로 시행한 후방 감압술 후 척추관 팽창과 관련된 수술 전 인자 분석)

Byung-Wan Choi (최병완); Seung Chul Kim (김승철)

Analysis of Preoperative Factors Affecting Postoperative Spinal Canal Expansion after Posterior Decompression for the Treatment of Multilevel Cervical Myelopathy

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2019, 26(2), pp.33-39
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery
Published : June 30, 2019

Byung-Wan Choi ¹, Seung Chul Kim ²

¹인제대학교
²인제대학교 해운대 백병원 정형외과

Accredited

ABSTRACT

Study Design: Retrospective analysis Objectives: To evaluate preoperative factors related with spinal canal expansion after posterior decompression for the treatment of multilevel cervical myelopathy. Summary of Literature Review: Data about preoperative factors related with spinal canal expansion after posterior cervical decompression surgery are inconsistent. Materials and Methods: We reviewed 67 patients with cervical myelopathy who underwent posterior laminectomy or laminoplasty. Radiologically, we evaluated the C2-7 Cobb angle and range of motion using X-rays from the preoperative assessment and final followup. Expansion of the spinal canal at 6 weeks postoperatively was evaluated using magnetic resonance imaging and compared with the preoperative values. The preoperative factors of age, sex, number of operated levels, operation method, and radiological parameters were investigated as factors potentially related to postoperative spinal canal expansion using multivariate regression and correlation analyses. The clinical outcome was analyzed by the Neck Disability Index (NDI) and Japanese Orthopaedic Association (JOA) scores. Results: The postoperative spinal canal expansion was 4.76 mm in sagittal images and 4.31 mm in axial images, with higher values observed in males and cases of severe preoperative cord compression. A lordotic preoperative Cobb angle was related to postoperative spinal canal expansion and JOA score improvement, but without statistical significance. The clinical outcomes of NDI (18.3→14.8) and JOA scores (10.81→14.6) showed improvement, but were not significantly related with any preoperative factors. Conclusions: The amount of preoperative spinal canal stenosis was associated with postoperative spinal canal expansion after posterior decompression in multilevel cervical myelopathy. The preoperative Cobb angle was not related to postoperative spinal canal expansion or clinical improvement. Key Words: Cervical myelopathy, Posterior decompression, Spinal canal expansion, MRI, Cobb angle

KEYWORDS

Cervical myelopathy, Posterior decompression, Spinal canal expansion, MRI, Cobb angle

Citation status

* References for papers published after 2023 are currently being built.

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Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03