Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?
Abstract
:1. Introduction
2. Materials & Methods
2.1. Study Design, Setting, Participants
2.2. Variables
2.3. Primary Outcome
2.4. Quantitative Variables
2.5. Statistical Methods
3. Results
3.1. Descriptive Data
3.2. Outcome Data
3.3. Main Result
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Laminoplasty Only N = 61 | +Partial C3 Laminectomy N = 39 | p Value | |
---|---|---|---|
Male gender | 43 (70.5%) | 21 (53.9%) | 0.091 |
Age | 66.4 ± 1.3 | 59.4 ± 2.3 | 0.012 |
Height (cm) | 170.3 ± 1.4 | 169.5 ± 1.5 | 0.349 |
Weight (kg) | 82.4 ± 2.4 | 81.8 ± 2.5 | 0.870 |
Body Mass Index | 28.5 ± 0.8 | 28.5 ± 0.7 | 0.983 |
Not current smoker | 55 (94.8%) | 34 (91.9%) | 0.566 |
Diabetes | 12 (20.0%) | 4 (10.3%) | 0.198 |
Coronary Artery Disease | 8 (13.3%) | 2 (5.1%) | 0.186 |
Peripheral Vascular Disease | 1 (1.67%) | 0 (0.0%) | 0.418 |
Chronic Kidney Disease | 4 (6.7%) | 1 (2.6%) | 0.362 |
Osteoporosis | 5 (8.3%) | 2 (5.1%) | 0.543 |
American Society of Anesthesiologists (ASA) Classification | |||
1 | 0 (0.0%) | 2 (5.3%) | 0.273 |
2 | 30 (63.8%) | 22 (57.9%) | |
3 | 17 (36.2%) | 14 (36.8%) | |
Median Number of Intervertebral Levels Decompressed [Interquartile Range] | 4 [4, 4] | 3 [3, 3] | <0.001 * |
Estimated Blood Loss (mL) | 179.0 ± 24.3 | 142.0 ± 12.2 | 0.178 |
Operative Time (minutes) | 134.0 ± 8.2 | 138.8 ± 5.1 | 0.619 |
Length of Stay (days) | 4.6 ± 0.9 | 3.5 ± 0.2 | 0.346 |
Change in Cervical Lordosis | |||
No change (<5°) | 40 (65.6%) | 29 (74.3%) | 0.644 |
Mild change (5–10°) | 9 (14.8%) | 4 (10.3%) | |
Moderate change (>10°) | 12 (19.7%) | 6 (15.4%) | |
90-day Readmission Rate | 1 (1.6%) | 2 (5.1%) | 0.318 |
1-year Reoperation Rate | 0 | 1 (2.5%) | 0.209 |
Median Follow-up [Range], months | 26.5 months [12.2 months–9.0 years] | 15.3 months [12.1 months–6.4 years] | 0.002 |
Laminoplasty Only | +Partial C3 Laminectomy | p Value | |
---|---|---|---|
Preoperative Measurements | |||
Cervical Lordosis | 13.2° ± 1.2 | 11.1° ± 1.3 | 0.259 |
T1 Slope | 32.9° ± 1.3 | 29.3° ± 1.6 | 0.073 |
T1 Slope–Cervical Lordosis | 19.9° ± 1.2 | 18.6° ± 1.1 | 0.485 |
Cervical–Sagittal Vertical Axis (mm) | 31.5 ± 2.1 | 27.4 ± 2.1 | 0.193 |
Global Measurements | |||
Pelvic Incidence | 54.4° ± 2.2 | 60.1° ± 2.3 | 0.085 |
Pelvic Tilt | 21.1° ± 1.7 | 19.5° ± 1.7 | 0.503 |
Lumbar Lordosis | 43.5° ± 2.9 | 52.4° ± 3.4 | 0.056 |
Sagittal Vertical Axis (mm) | 28.9 ± 7.1 | 30.4 ± 7.0 | 0.891 |
Postoperative Measurements | |||
Cervical Lordosis | 9.4° ± 1.4 | 11.2° ± 1.2 | 0.331 |
T1 Slope | 31.2° ± 1.2 | 27.8° ± 1.6 | 0.080 |
T1 Slope–Cervical Lordosis | 21.7° ± 1.6 | 18.2° ± 1.5 | 0.126 |
Cervical–Sagittal Vertical Axis (mm) | 34.0 ± 2.0 | 36.2 ± 2.4 | 0.480 |
Adjusted Odds Ratio [95% Confidence Interval] | p Value | |
---|---|---|
Partial C3 “Dome” Laminectomy | 0.72 [0.29–1.8] | 0.479 |
Age | 1.01 [0.97–1.05] | 0.593 |
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Macki, M.; Chryssikos, T.; Meade, S.M.; Aabedi, A.A.; Letchuman, V.; Ambati, V.; Krishnan, N.; Tawil, M.E.; Tichelaar, S.; Rivera, J.; et al. Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra? J. Clin. Med. 2023, 12, 7594. https://doi.org/10.3390/jcm12247594
Macki M, Chryssikos T, Meade SM, Aabedi AA, Letchuman V, Ambati V, Krishnan N, Tawil ME, Tichelaar S, Rivera J, et al. Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra? Journal of Clinical Medicine. 2023; 12(24):7594. https://doi.org/10.3390/jcm12247594
Chicago/Turabian StyleMacki, Mohamed, Timothy Chryssikos, Seth M. Meade, Alexander A. Aabedi, Vijay Letchuman, Vardhaan Ambati, Nishanth Krishnan, Michael E. Tawil, Seth Tichelaar, Joshua Rivera, and et al. 2023. "Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?" Journal of Clinical Medicine 12, no. 24: 7594. https://doi.org/10.3390/jcm12247594