Range of motion loss after cervical laminoplasty: A prospective study with minimum 5-year follow-up data

Seong Jae Hyun, K. Daniel Riew, Seung Chul Rhim

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background context: Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period. Purpose: We previously reported our early data on postlaminoplasty cervical ROM. In this article, we describe our minimum 5-year follow-up data to identify the time-dependent change in ROM after cervical laminoplasty. Study design: A prospective cohort study. Patient sample: The procedure was performed in 23 patients. Eighteen patients with a minimum 5-year follow-up were included in the study. Outcome measures: The time-dependent neck ROM changes observed in the neutral, flexion, and extension radiographs were used to measure the radiological outcome. The Japanese Orthopaedic Association classification and a numerical rating scale of axial neck pain and arm pain were used to evaluate clinical outcome. Methods: Twenty-three patients who received unilateral open-door laminoplasties, including miniplate fixation over three levels, were serially evaluated at regular set intervals postoperatively. Eighteen patients with a minimum 5-year follow-up were included in the study. The mean follow-up period was 68.1 months (range, 60-78 months). Nine patients had ossification of posterior longitudinal ligament (OPLL) and nine patients had cervical spondylotic myelopathy (CSM). Enrolled patients were divided into subgroups (OPLL vs. CSM; autofusion vs. nonautofusion) to compare the ROM between the groups. We evaluated the time-dependent neck ROM changes by taking neutral, flexion, and extension radiographs preoperatively and at 1, 3, 6, 9, 12, 18, and 24 months postoperatively. Follow-up radiographs were taken annually after a 2-year follow-up. Results: The preoperative and 1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-month postoperative ROM figures were 39.9±11.2°, 35.0±9.2°, 33.0±11.0°, 30.1±10.4°, 25.8±13.1°, 24.7±10.0°, 23.8±6.5°, 24.6±8.3°, and 23.6±9.4°, respectively, and at the most recent follow-up, ROM was 24.5±10.1°. Thus, the mean ROM decreased by 15.4±8.4°(38.5%) by the last follow-up (p<.0001). In the OPLL group, we observed a more limited cervical ROM than in the CSM group (47.2% vs. 72.7%). As expected, in the laminar autofusion group, the ROM decreased significantly (55.6% decrease), whereas in the nonautofusion group, the ROM decreased less significantly (13.4% decrease) at the last follow-up. Postoperative axial pain did not correlate with the cervical ROM. Conclusions: These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs.

Original languageEnglish
Pages (from-to)384-390
Number of pages7
JournalSpine Journal
Volume13
Issue number4
DOIs
StatePublished - 1 Apr 2013

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Articular Range of Motion
Prospective Studies
Ossification of Posterior Longitudinal Ligament
Spinal Cord Diseases
Laminoplasty
Neck
Outcome Assessment (Health Care)
Neck Pain
Postoperative Pain

Keywords

  • Cervical spine
  • Laminoplasty
  • Ossification of the posterior longitudinal ligament
  • Range of motion
  • Spondylosis

Cite this

@article{aac7f9768051427fb8f1e523c5892d53,
title = "Range of motion loss after cervical laminoplasty: A prospective study with minimum 5-year follow-up data",
abstract = "Background context: Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period. Purpose: We previously reported our early data on postlaminoplasty cervical ROM. In this article, we describe our minimum 5-year follow-up data to identify the time-dependent change in ROM after cervical laminoplasty. Study design: A prospective cohort study. Patient sample: The procedure was performed in 23 patients. Eighteen patients with a minimum 5-year follow-up were included in the study. Outcome measures: The time-dependent neck ROM changes observed in the neutral, flexion, and extension radiographs were used to measure the radiological outcome. The Japanese Orthopaedic Association classification and a numerical rating scale of axial neck pain and arm pain were used to evaluate clinical outcome. Methods: Twenty-three patients who received unilateral open-door laminoplasties, including miniplate fixation over three levels, were serially evaluated at regular set intervals postoperatively. Eighteen patients with a minimum 5-year follow-up were included in the study. The mean follow-up period was 68.1 months (range, 60-78 months). Nine patients had ossification of posterior longitudinal ligament (OPLL) and nine patients had cervical spondylotic myelopathy (CSM). Enrolled patients were divided into subgroups (OPLL vs. CSM; autofusion vs. nonautofusion) to compare the ROM between the groups. We evaluated the time-dependent neck ROM changes by taking neutral, flexion, and extension radiographs preoperatively and at 1, 3, 6, 9, 12, 18, and 24 months postoperatively. Follow-up radiographs were taken annually after a 2-year follow-up. Results: The preoperative and 1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-month postoperative ROM figures were 39.9±11.2°, 35.0±9.2°, 33.0±11.0°, 30.1±10.4°, 25.8±13.1°, 24.7±10.0°, 23.8±6.5°, 24.6±8.3°, and 23.6±9.4°, respectively, and at the most recent follow-up, ROM was 24.5±10.1°. Thus, the mean ROM decreased by 15.4±8.4°(38.5{\%}) by the last follow-up (p<.0001). In the OPLL group, we observed a more limited cervical ROM than in the CSM group (47.2{\%} vs. 72.7{\%}). As expected, in the laminar autofusion group, the ROM decreased significantly (55.6{\%} decrease), whereas in the nonautofusion group, the ROM decreased less significantly (13.4{\%} decrease) at the last follow-up. Postoperative axial pain did not correlate with the cervical ROM. Conclusions: These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs.",
keywords = "Cervical spine, Laminoplasty, Ossification of the posterior longitudinal ligament, Range of motion, Spondylosis",
author = "Hyun, {Seong Jae} and Riew, {K. Daniel} and Rhim, {Seung Chul}",
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Range of motion loss after cervical laminoplasty : A prospective study with minimum 5-year follow-up data. / Hyun, Seong Jae; Riew, K. Daniel; Rhim, Seung Chul.

In: Spine Journal, Vol. 13, No. 4, 01.04.2013, p. 384-390.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Range of motion loss after cervical laminoplasty

T2 - A prospective study with minimum 5-year follow-up data

AU - Hyun, Seong Jae

AU - Riew, K. Daniel

AU - Rhim, Seung Chul

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Background context: Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period. Purpose: We previously reported our early data on postlaminoplasty cervical ROM. In this article, we describe our minimum 5-year follow-up data to identify the time-dependent change in ROM after cervical laminoplasty. Study design: A prospective cohort study. Patient sample: The procedure was performed in 23 patients. Eighteen patients with a minimum 5-year follow-up were included in the study. Outcome measures: The time-dependent neck ROM changes observed in the neutral, flexion, and extension radiographs were used to measure the radiological outcome. The Japanese Orthopaedic Association classification and a numerical rating scale of axial neck pain and arm pain were used to evaluate clinical outcome. Methods: Twenty-three patients who received unilateral open-door laminoplasties, including miniplate fixation over three levels, were serially evaluated at regular set intervals postoperatively. Eighteen patients with a minimum 5-year follow-up were included in the study. The mean follow-up period was 68.1 months (range, 60-78 months). Nine patients had ossification of posterior longitudinal ligament (OPLL) and nine patients had cervical spondylotic myelopathy (CSM). Enrolled patients were divided into subgroups (OPLL vs. CSM; autofusion vs. nonautofusion) to compare the ROM between the groups. We evaluated the time-dependent neck ROM changes by taking neutral, flexion, and extension radiographs preoperatively and at 1, 3, 6, 9, 12, 18, and 24 months postoperatively. Follow-up radiographs were taken annually after a 2-year follow-up. Results: The preoperative and 1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-month postoperative ROM figures were 39.9±11.2°, 35.0±9.2°, 33.0±11.0°, 30.1±10.4°, 25.8±13.1°, 24.7±10.0°, 23.8±6.5°, 24.6±8.3°, and 23.6±9.4°, respectively, and at the most recent follow-up, ROM was 24.5±10.1°. Thus, the mean ROM decreased by 15.4±8.4°(38.5%) by the last follow-up (p<.0001). In the OPLL group, we observed a more limited cervical ROM than in the CSM group (47.2% vs. 72.7%). As expected, in the laminar autofusion group, the ROM decreased significantly (55.6% decrease), whereas in the nonautofusion group, the ROM decreased less significantly (13.4% decrease) at the last follow-up. Postoperative axial pain did not correlate with the cervical ROM. Conclusions: These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs.

AB - Background context: Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period. Purpose: We previously reported our early data on postlaminoplasty cervical ROM. In this article, we describe our minimum 5-year follow-up data to identify the time-dependent change in ROM after cervical laminoplasty. Study design: A prospective cohort study. Patient sample: The procedure was performed in 23 patients. Eighteen patients with a minimum 5-year follow-up were included in the study. Outcome measures: The time-dependent neck ROM changes observed in the neutral, flexion, and extension radiographs were used to measure the radiological outcome. The Japanese Orthopaedic Association classification and a numerical rating scale of axial neck pain and arm pain were used to evaluate clinical outcome. Methods: Twenty-three patients who received unilateral open-door laminoplasties, including miniplate fixation over three levels, were serially evaluated at regular set intervals postoperatively. Eighteen patients with a minimum 5-year follow-up were included in the study. The mean follow-up period was 68.1 months (range, 60-78 months). Nine patients had ossification of posterior longitudinal ligament (OPLL) and nine patients had cervical spondylotic myelopathy (CSM). Enrolled patients were divided into subgroups (OPLL vs. CSM; autofusion vs. nonautofusion) to compare the ROM between the groups. We evaluated the time-dependent neck ROM changes by taking neutral, flexion, and extension radiographs preoperatively and at 1, 3, 6, 9, 12, 18, and 24 months postoperatively. Follow-up radiographs were taken annually after a 2-year follow-up. Results: The preoperative and 1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-month postoperative ROM figures were 39.9±11.2°, 35.0±9.2°, 33.0±11.0°, 30.1±10.4°, 25.8±13.1°, 24.7±10.0°, 23.8±6.5°, 24.6±8.3°, and 23.6±9.4°, respectively, and at the most recent follow-up, ROM was 24.5±10.1°. Thus, the mean ROM decreased by 15.4±8.4°(38.5%) by the last follow-up (p<.0001). In the OPLL group, we observed a more limited cervical ROM than in the CSM group (47.2% vs. 72.7%). As expected, in the laminar autofusion group, the ROM decreased significantly (55.6% decrease), whereas in the nonautofusion group, the ROM decreased less significantly (13.4% decrease) at the last follow-up. Postoperative axial pain did not correlate with the cervical ROM. Conclusions: These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs.

KW - Cervical spine

KW - Laminoplasty

KW - Ossification of the posterior longitudinal ligament

KW - Range of motion

KW - Spondylosis

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