2022, Vol. 26 ›› Issue (36): 5862-5867

C2 and C3 vertebral arch bone impact after posterior cervical single open-door laminoplasty: lateral X-ray evaluation of cervical spine within 2 years

Zhong Hua, Guan Haishan   

Abstract: BACKGROUND: The phenomenon of C2 and C3 vertebral arch bone impact is easy to occur after posterior cervical single open-door laminoplasty, which leads to the limitation of postoperative cervical movement. The analysis of related factors is of great clinical significance.
OBJECTIVE: To analyze the related factors of C2 and C3 vertebral arch bone impact after posterior cervical single open-door laminoplasty, and to explore the etiology and pathogenesis of C2 and C3 vertebral arch bone impact.
METHODS: A retrospective analysis was performed in 95 patients with multi-level cervical spondylotic myelopathy who underwent posterior cervical single open-door laminoplasty and had complete follow-up data, at a mean age of (56.76±7.76) years old, including 33 males and 62 females. The patients were followed up to observe whether C2 and C3 vertebral arch bone impact occurred within 2 years using X-ray films. The patients were divided into impact group (n=31) and non-impact group (n=64). After univariate analysis, it suggested that preoperative ossification of posterior longitudinal ligament, postoperative cervical curvature, postoperative cervical mobility, and postoperative visual analogue scale score were the potential related factors of C2 and C3 vertebral arch bone impact. Finally, multivariable logistic regression analysis was included.
RESULTS AND CONCLUSION: (1) Among 95 patients, 31 cases had C2 and C3 vertebral arch bone impact, accounting for 33%. (2) The incidence of preoperative ossification of the posterior longitudinal ligament in the impact group was significantly higher than that in the non-impact group (P < 0.05). (3) There was no statistical significance in the preoperative cervical curvature, cervical motion range, Japanese Orthopaedic Association score, and visual analogue scale between the impact group and the non-impact group (P > 0.05). Cervical curvature and cervical motion range were significantly higher in the impact group than those in the non-impact group (P < 0.05). At the final follow-up, Japanese Orthopaedic Association score was not significantly different between the impact group and the non-impact group (P > 0.05). Visual analogue scale score was significantly higher in the impact group than that in the non-impact group (P < 0.05). (4) Postoperative axial symptoms occurred in 2 cases (6%) in the impact group and 3 cases (5%) in the non-impact group. (5) Multivariable logistic regression analysis suggested that low postoperative cervical curvature, low postoperative cervical motion range, and high postoperative visual analogue scale score were independent risk factors for C2 and C3 vertebral arch bone impact. It is indicated that C2 and C3 vertebral arch bone impact is one of the important reasons for the occurrence of axial symptoms and has a certain impact on the postoperative curative effect.
Key words: single open-door laminoplasty, vertebral arch bone impact, cervical curvature, cervical motion range, Japanese Orthopaedic Association score, visual analogue scale score