Radiological examination of postoperative cervical alignment and stability in patients with dialysis-associated spondylosis excluding destructive spondyloarthropathy: Comparison with patients with cervical spondylotic myelopathy

Satoshi Baba, Yoshihiro Matsumoto, Shinji Tomari, Takahiro Yasuhara, Hirokazu Saiwai, Akinobu Matsushita, Tatsuya Yufu, Mitsumasa Hayashida, Seiji Okada, Kenichi Kawaguchi, Kenichi Seo, Yasumasa Ito, Yasuharu Nakashima

研究成果: ジャーナルへの寄稿記事

抄録

Introduction: Several reports have demonstrated the surgical treatment strategy for patients with dialysis-associated spondylosis in the cervical spine (CDAS) with destructive spondyloarthropathy (DSA). However, studies focusing on the clinical outcome of patients with CDAS without DSA remain scarce. We aimed to review the treatment strategy of patients with CDAS but without DSA. Methods: The clinical data and surgical records of consecutive patients with CDAS without DSA (n = 9; D-group) and cervical spondylotic myelopathy (CSM) (n = 30; C-group) who underwent modified double-door laminoplasty(DDL) were reviewed retrospectively. We investigated four radiologic factors in the pre-and postoperative periods that have been reported to be the risk factors for worsening of clinical symptoms in various studies and examined statistical comparison between the D and C groups. Results: In the D group, the pre- versus postoperative C2-C7 sagittal angles were not significantly different, and only two patients (22%) had kyphosis postoperatively. There was a significant difference in the pre- and postoperative C2-C7 angles in the two groups (P = 0.031). Regarding the change in segmental alignment, the local open angle increased at the C4/C5 level in the D group. Also there was a significant difference in the local angles between the two groups at C4/5 and C5/6 (P = 0.00038, and 0.037), suggesting that postoperative segmental mobility at C4/5 and C5/6 was higher in the D group than in the C group. Conclusions: In the present study, DDL in patients with CDAS without DSA did not adversely affect the postoperative alignment and stability compared with CSM patients with CSM. However, patients in the D group may have a chance to develop DSA change at the C4/5 level in the future, and careful long-term follow-up is warranted.

元の言語英語
ページ(範囲)202-209
ページ数8
ジャーナルSpine Surgery and Related Research
2
発行部数3
DOI
出版物ステータス出版済み - 1 1 2018

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Spondylosis
Spondylarthropathies
Spinal Cord Diseases
Dialysis
Dilatation and Curettage
Kyphosis
Postoperative Period
Spine

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Orthopedics and Sports Medicine

これを引用

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title = "Radiological examination of postoperative cervical alignment and stability in patients with dialysis-associated spondylosis excluding destructive spondyloarthropathy: Comparison with patients with cervical spondylotic myelopathy",
abstract = "Introduction: Several reports have demonstrated the surgical treatment strategy for patients with dialysis-associated spondylosis in the cervical spine (CDAS) with destructive spondyloarthropathy (DSA). However, studies focusing on the clinical outcome of patients with CDAS without DSA remain scarce. We aimed to review the treatment strategy of patients with CDAS but without DSA. Methods: The clinical data and surgical records of consecutive patients with CDAS without DSA (n = 9; D-group) and cervical spondylotic myelopathy (CSM) (n = 30; C-group) who underwent modified double-door laminoplasty(DDL) were reviewed retrospectively. We investigated four radiologic factors in the pre-and postoperative periods that have been reported to be the risk factors for worsening of clinical symptoms in various studies and examined statistical comparison between the D and C groups. Results: In the D group, the pre- versus postoperative C2-C7 sagittal angles were not significantly different, and only two patients (22{\%}) had kyphosis postoperatively. There was a significant difference in the pre- and postoperative C2-C7 angles in the two groups (P = 0.031). Regarding the change in segmental alignment, the local open angle increased at the C4/C5 level in the D group. Also there was a significant difference in the local angles between the two groups at C4/5 and C5/6 (P = 0.00038, and 0.037), suggesting that postoperative segmental mobility at C4/5 and C5/6 was higher in the D group than in the C group. Conclusions: In the present study, DDL in patients with CDAS without DSA did not adversely affect the postoperative alignment and stability compared with CSM patients with CSM. However, patients in the D group may have a chance to develop DSA change at the C4/5 level in the future, and careful long-term follow-up is warranted.",
author = "Satoshi Baba and Yoshihiro Matsumoto and Shinji Tomari and Takahiro Yasuhara and Hirokazu Saiwai and Akinobu Matsushita and Tatsuya Yufu and Mitsumasa Hayashida and Seiji Okada and Kenichi Kawaguchi and Kenichi Seo and Yasumasa Ito and Yasuharu Nakashima",
year = "2018",
month = "1",
day = "1",
doi = "10.22603/ssrr.2017-0068",
language = "English",
volume = "2",
pages = "202--209",
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TY - JOUR

T1 - Radiological examination of postoperative cervical alignment and stability in patients with dialysis-associated spondylosis excluding destructive spondyloarthropathy

T2 - Comparison with patients with cervical spondylotic myelopathy

AU - Baba, Satoshi

AU - Matsumoto, Yoshihiro

AU - Tomari, Shinji

AU - Yasuhara, Takahiro

AU - Saiwai, Hirokazu

AU - Matsushita, Akinobu

AU - Yufu, Tatsuya

AU - Hayashida, Mitsumasa

AU - Okada, Seiji

AU - Kawaguchi, Kenichi

AU - Seo, Kenichi

AU - Ito, Yasumasa

AU - Nakashima, Yasuharu

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Several reports have demonstrated the surgical treatment strategy for patients with dialysis-associated spondylosis in the cervical spine (CDAS) with destructive spondyloarthropathy (DSA). However, studies focusing on the clinical outcome of patients with CDAS without DSA remain scarce. We aimed to review the treatment strategy of patients with CDAS but without DSA. Methods: The clinical data and surgical records of consecutive patients with CDAS without DSA (n = 9; D-group) and cervical spondylotic myelopathy (CSM) (n = 30; C-group) who underwent modified double-door laminoplasty(DDL) were reviewed retrospectively. We investigated four radiologic factors in the pre-and postoperative periods that have been reported to be the risk factors for worsening of clinical symptoms in various studies and examined statistical comparison between the D and C groups. Results: In the D group, the pre- versus postoperative C2-C7 sagittal angles were not significantly different, and only two patients (22%) had kyphosis postoperatively. There was a significant difference in the pre- and postoperative C2-C7 angles in the two groups (P = 0.031). Regarding the change in segmental alignment, the local open angle increased at the C4/C5 level in the D group. Also there was a significant difference in the local angles between the two groups at C4/5 and C5/6 (P = 0.00038, and 0.037), suggesting that postoperative segmental mobility at C4/5 and C5/6 was higher in the D group than in the C group. Conclusions: In the present study, DDL in patients with CDAS without DSA did not adversely affect the postoperative alignment and stability compared with CSM patients with CSM. However, patients in the D group may have a chance to develop DSA change at the C4/5 level in the future, and careful long-term follow-up is warranted.

AB - Introduction: Several reports have demonstrated the surgical treatment strategy for patients with dialysis-associated spondylosis in the cervical spine (CDAS) with destructive spondyloarthropathy (DSA). However, studies focusing on the clinical outcome of patients with CDAS without DSA remain scarce. We aimed to review the treatment strategy of patients with CDAS but without DSA. Methods: The clinical data and surgical records of consecutive patients with CDAS without DSA (n = 9; D-group) and cervical spondylotic myelopathy (CSM) (n = 30; C-group) who underwent modified double-door laminoplasty(DDL) were reviewed retrospectively. We investigated four radiologic factors in the pre-and postoperative periods that have been reported to be the risk factors for worsening of clinical symptoms in various studies and examined statistical comparison between the D and C groups. Results: In the D group, the pre- versus postoperative C2-C7 sagittal angles were not significantly different, and only two patients (22%) had kyphosis postoperatively. There was a significant difference in the pre- and postoperative C2-C7 angles in the two groups (P = 0.031). Regarding the change in segmental alignment, the local open angle increased at the C4/C5 level in the D group. Also there was a significant difference in the local angles between the two groups at C4/5 and C5/6 (P = 0.00038, and 0.037), suggesting that postoperative segmental mobility at C4/5 and C5/6 was higher in the D group than in the C group. Conclusions: In the present study, DDL in patients with CDAS without DSA did not adversely affect the postoperative alignment and stability compared with CSM patients with CSM. However, patients in the D group may have a chance to develop DSA change at the C4/5 level in the future, and careful long-term follow-up is warranted.

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DO - 10.22603/ssrr.2017-0068

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JO - Spine Surgery and Related Research

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SN - 2432-261X

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