Risk Factors for Cervical Deformity After Posterior Cervical Decompression Surgery: A Multicenter Study.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Deformity Correction

Background:

• Posterior decompression surgery for cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) is frequently performed.
• Postoperative cervical deformity (CD) is a potential complication of these procedures.
• Identifying risk factors for CD is crucial for improving surgical outcomes.

Purpose of the Study:

• To investigate the risk factors associated with the development of cervical deformity (CD) after posterior decompression surgery for CSM and OPLL.

Main Methods:

• Retrospective multicenter study of 193 patients undergoing laminoplasty or laminectomy for CSM or OPLL.
• Cervical deformity (CD) defined as C2-7 sagittal vertical axis (SVA) ≥ 40 mm or cervical lordosis (CL) ≤ -10°.
• Patients categorized into groups based on preoperative and postoperative CD status.

Main Results:

• Preoperative C2-7 SVA ≥ 30 mm (OR: 19.0) and preoperative CL ≤ 2° (OR: 42.0) were significant risk factors for developing CD.
• Decompression of the C2 or C7 lamina (OR 3.1) was associated with increased risk of CD.
• Higher rates of C2 decompression and C5 palsy were observed in patients who developed postoperative CD.

Conclusions:

• Avoiding decompression of the C2 or C7 lamina is important for preventing postoperative cervical deformity.
• For patients with preoperative C2-7 SVA ≥ 30 mm or CL ≤ 2°, discussing risks and considering fusion surgery is recommended.
• These findings aid in optimizing surgical strategies to minimize the risk of cervical deformity.