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Article: 'Spring-back' closure associated with open-door cervical laminoplasty

Title'Spring-back' closure associated with open-door cervical laminoplasty
Authors
Issue Date2011
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spinee
Citation
The Spine Journal, 2011, v. 11 n. 9, p. 832-838 How to Cite?
AbstractBACKGROUND CONTEXT: Spring-back complication after open-door laminoplasty as described by Hirabayashi is a well-known risk, but its definition, incidence, and associated neurologic outcome remain unclear. OBJECTIVE: To investigate the incidence and the neurologic consequence of spring-back closure after open-door laminoplasty. STUDY DESIGN: A retrospective radiographic and clinical review. OUTCOME MEASURES: Lateral cervical spine X-rays were evaluated. Anteroposterior diameters (APD) of the vertebral canal of C3-C7 were measured. Spring-back was defined as loss of APD on follow-up in comparison to immediate postoperative canal expansion. The loss of the end-on lamina silhouette with consequent reappearance of the lateral profile of the spinous processes was also assessed to verify the presence of spring-back. Spring-back closure was classified based on whether the collapse was total or partial, and whether all the operated levels or only a subset had collapsed (ie, complete vs. partial closure, segmental closure vs. total-construct closure). Neurologic status was documented using the Japanese Orthopaedic Association (JOA) score. METHODS: Thirty consecutive patients who underwent open-door laminoplasty from 1995 to 2005 at a single institution with a minimum follow-up of 2 years were assessed. They were all operated on using the classic Hirabayashi technique. Radiographic outcomes were assessed independently by two individuals. RESULTS: Sixteen men and 14 women with an average follow-up of 5 years (range, 2-12 years) were included. Of these patients, 24 had cervical spondylotic myelopathy and six had ossification of the posterior longitudinal ligament. Spring-back closure was found in three patients (10%) and 7 of 117 laminae (6%) within 6 months of the operation, which was further confirmed by computed tomography and magnetic resonance imaging. All spring-back closures were partial segmental closures. Gender and age were not significant factors related to spring back (p>.05). The mean JOA score on follow-up was 12.5, with a recovery rate of 40%. All patients with spring back and available JOA data exhibited postoperative neurologic deterioration. Of the three patients with spring back, two patients underwent revision surgery, whereas one declined. CONCLUSIONS: Spring-back closure occurred in 10% of our patients at or before 6 months after surgery. The incidence of spring-back by level (ie, 117 laminae) was 6%, mainly occurring at the lower cervical spine. All spring-back closures were partial segmental closures, most commonly involving C5 and C6. Postoperative neurologic deficit was associated with spring-back closure; therefore, surgeons should adopt preemptive surgical measures to prevent the occurrence of such a complication.
Persistent Identifierhttp://hdl.handle.net/10722/137453
ISSN
2015 Impact Factor: 2.66
2015 SCImago Journal Rankings: 1.153
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, HQen_HK
dc.contributor.authorMak, KCen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorEl-Fiky, Ten_HK
dc.contributor.authorWong, YWen_HK
dc.contributor.authorLuo, ZJen_HK
dc.contributor.authorKang, Xen_HK
dc.contributor.authorCheung, WYen_HK
dc.contributor.authorLuk, KDKen_HK
dc.contributor.authorCheung, KMCen_HK
dc.date.accessioned2011-08-26T14:25:26Z-
dc.date.available2011-08-26T14:25:26Z-
dc.date.issued2011en_HK
dc.identifier.citationThe Spine Journal, 2011, v. 11 n. 9, p. 832-838en_HK
dc.identifier.issn1529-9430en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137453-
dc.description.abstractBACKGROUND CONTEXT: Spring-back complication after open-door laminoplasty as described by Hirabayashi is a well-known risk, but its definition, incidence, and associated neurologic outcome remain unclear. OBJECTIVE: To investigate the incidence and the neurologic consequence of spring-back closure after open-door laminoplasty. STUDY DESIGN: A retrospective radiographic and clinical review. OUTCOME MEASURES: Lateral cervical spine X-rays were evaluated. Anteroposterior diameters (APD) of the vertebral canal of C3-C7 were measured. Spring-back was defined as loss of APD on follow-up in comparison to immediate postoperative canal expansion. The loss of the end-on lamina silhouette with consequent reappearance of the lateral profile of the spinous processes was also assessed to verify the presence of spring-back. Spring-back closure was classified based on whether the collapse was total or partial, and whether all the operated levels or only a subset had collapsed (ie, complete vs. partial closure, segmental closure vs. total-construct closure). Neurologic status was documented using the Japanese Orthopaedic Association (JOA) score. METHODS: Thirty consecutive patients who underwent open-door laminoplasty from 1995 to 2005 at a single institution with a minimum follow-up of 2 years were assessed. They were all operated on using the classic Hirabayashi technique. Radiographic outcomes were assessed independently by two individuals. RESULTS: Sixteen men and 14 women with an average follow-up of 5 years (range, 2-12 years) were included. Of these patients, 24 had cervical spondylotic myelopathy and six had ossification of the posterior longitudinal ligament. Spring-back closure was found in three patients (10%) and 7 of 117 laminae (6%) within 6 months of the operation, which was further confirmed by computed tomography and magnetic resonance imaging. All spring-back closures were partial segmental closures. Gender and age were not significant factors related to spring back (p>.05). The mean JOA score on follow-up was 12.5, with a recovery rate of 40%. All patients with spring back and available JOA data exhibited postoperative neurologic deterioration. Of the three patients with spring back, two patients underwent revision surgery, whereas one declined. CONCLUSIONS: Spring-back closure occurred in 10% of our patients at or before 6 months after surgery. The incidence of spring-back by level (ie, 117 laminae) was 6%, mainly occurring at the lower cervical spine. All spring-back closures were partial segmental closures, most commonly involving C5 and C6. Postoperative neurologic deficit was associated with spring-back closure; therefore, surgeons should adopt preemptive surgical measures to prevent the occurrence of such a complication.en_HK
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spineeen_HK
dc.relation.ispartofThe Spine Journalen_HK
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in The Spine Journal. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Spine Journal, 2011, v. 11 n. 9, p. 832-838. DOI: 10.1016/j.spinee.2011.07.026-
dc.rights.uriCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCervical Vertebrae - radiography - surgery-
dc.subject.meshLaminectomy - adverse effects-
dc.subject.meshOssification of Posterior Longitudinal Ligament - radiography - surgery-
dc.subject.meshPostoperative Complications - epidemiology - pathology - radiography-
dc.subject.meshSpondylosis - radiography - surgery-
dc.title'Spring-back' closure associated with open-door cervical laminoplastyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1529-9430&volume=&spage=&epage=&date=2011&atitle=“Spring-back”+closure+associated+with+open-door+cervical+laminoplastyen_US
dc.identifier.emailMak, KC: kincmak@hku.hken_HK
dc.identifier.emailSamartzis, D: dspine@hku.hken_HK
dc.identifier.emailWong, YW: yatwa@hkucc.hku.hken_HK
dc.identifier.emailCheung, WY: lcheung@hkucc.hku.hk-
dc.identifier.emailLuk, KDK: hcm21000@hku.hk-
dc.identifier.emailCheung, KMC: cheungmc@hku.hk-
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.spinee.2011.07.026en_HK
dc.identifier.pmid21890423en_HK
dc.identifier.scopuseid_2-s2.0-80053316822en_HK
dc.identifier.hkuros207338en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80053316822&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume11en_HK
dc.identifier.issue9en_HK
dc.identifier.spage832en_HK
dc.identifier.epage838en_HK
dc.identifier.isiWOS:000296276100006-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK
dc.identifier.scopusauthoridCheung, WY=24504264600en_HK
dc.identifier.scopusauthoridKang, X=36844160400en_HK
dc.identifier.scopusauthoridLuo, ZJ=8510080000en_HK
dc.identifier.scopusauthoridWong, YW=36247941700en_HK
dc.identifier.scopusauthoridElFiky, T=53864807300en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridMak, KC=51663738600en_HK
dc.identifier.scopusauthoridWang, HQ=53865666900en_HK
dc.identifier.citeulike9776666-

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