Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?

作者：Mohamed Macki, Timothy Chryssikos, Seth M. Meade, Alexander A. Aabedi, Vijay Letchuman, Vardhaan Ambati, Nishanth Krishnan, Michael E. Tawil, Seth Tichelaar, Joshua Rivera, Andrew K. Chan, Lee A. Tan, Dean Chou, Praveen V. Mummaneni · 发表于：Journal of Clinical Medicine · 年份：2023 · DOI：10.3390/jcm12247594 · 被引用次数：6 · 研究领域：Cervical and Thoracic Myelopathy、Spine and Intervertebral Disc Pathology、Spinal Fractures and Fixation Techniques

Introduction: In a multilevel cervical laminoplasty operation for patients with cervical spondylotic myelopathy (CSM), a partial or complete C3 laminectomy may be performed at the upper level instead of a C3 plated laminoplasty. It is unknown whether C3 technique above the laminoplasty affects loss of cervical lordosis or range of motion. Methods: Patients undergoing multilevel laminoplasty of the cervical spine (C3–C6/C7) at a single institution were retrospectively reviewed. Patients were divided into two cohorts based on surgical technique at C3: C3–C6/C7 plated laminoplasty (“C3 laminoplasty only”, N = 61), C3 partial or complete laminectomy, plus C4–C6/C7 plated laminoplasty (N = 39). All patients had at least 1-year postoperative X-ray treatment. Results: Of 100 total patients, C3 laminoplasty and C3 laminectomy were equivalent in all demographic data, except for age (66.4 vs. 59.4 years, p = 0.012). None of the preoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (13.1° vs. 11.1°, p = 0.259), T1 slope (32.9° vs. 29.2°, p = 0.072), T1 slope–cervical lordosis (19.8° vs. 18.6°, p = 0.485), or cervical sagittal vertical axis (3.1 cm vs. 2.7 cm, p = 0.193). None of the postoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (9.4° vs. 11.2°, p = 0.369), T1 slope–cervical lordosis (21.7° vs. 18.1°, p = 0.126), to cervical sagittal vertical axis (...