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Cervical Range of Motion and Alignment After Laminoplasty Preserving or Reattaching the Semispinalis Cervicis Inserted Into Axis

2007; Lippincott Williams & Wilkins; Volume: 20; Issue: 8 Linguagem: Inglês

10.1097/bsd.0b013e318046363a

1539-2465

Kazunari Takeuchi, Tōru Yokoyama, Atsushi Ono, Takuya Numasawa, Kanichiro Wada, Gentaro Kumagai, Junji Ito, Kazumasa Ueyama, Satoshi Toh,

Spinal Fractures and Fixation Techniques

Study Design A radiographic study in 111 patients using radiographs was conducted. Objective To clarify whether the modified laminoplasty with C3 laminectomy preserving the semispinalis cervicis (SSC) inserted into C2 could maintain the postopertive range of motion (ROM) and sagittal alignment compared with conventional C3-C7 laminoplasty reattaching the muscle to C2. Summary of Background Data Intraoperative injury of the SSC is relevant to the significant loss of ROM and the malalignment after laminoplasty. To expose the C3 lamina, however, the SSC inserted into C2 could not be preserved in conventional C3-C7 laminoplasty. Methods The ROM and sagittal alignment of 70 patients (group A) (52 men, 18 women, mean age 59 y, mean follow-up period 1 y and 7 mo) with C4-C7 laminoplasty with C3 laminectomy were compared with those of 41 patients (group B) (28 men, 13 women, mean age 59 y, mean follow-up period 2 y and 6 mo) with C3-C7 laminoplasty using radiographs of the cervical spine. Results Regarding C2-C7 ROM, the postoperative ROM was larger (P=0.003) and the decrease rate of ROM was smaller (P=0.0006), and decreased ROM in extension was smaller (P<0.0001) in group A. Regarding O-C2 ROM, the increased ROM was smaller (P=0.043) and increased ROM in extension was smaller (P=0.001) in group A. Regarding O-C7 ROM, the postoperative ROM was larger (P=0.029) in group A. Regarding the cervical alignment, the increased lordotic angle at O-C2 was smaller (P=0.046) in group A. Conclusions This modified laminoplasty preserving the SSC inserted into C2 is an effective procedure for maintaining postoperative ROM, especially in extension, and sagittal alignment of the upper cervical spine well.