AI Article Synopsis

  • Cervical kyphotic deformity can occur after atlantoaxial fixation and cervical expansive laminoplasty, but little is known about this risk when both procedures are done simultaneously.
  • In a study of 5 patients (average age 68) with underlying conditions like rheumatoid arthritis, cervical alignment was evaluated before and after the combined surgeries by measuring angles on lateral radiographs.
  • Results showed that while some angles remained stable, the angle between C2 and C5 decreased significantly post-surgery, indicating a potential for developing cervical kyphosis as a complication from this procedure combination.

Article Abstract

Cervical kyphotic deformity is one of the well-known complications after atlantoaxial fixation or cervical expansive laminoplasty, but to our knowledge there is no information about postoperative cervical kyphosis after performing these operations simultaneously. The aims of this study were to evaluate the changes in the cervical alignment after simultaneous atlantoaxial fixation and cervical expansive laminoplasty, and to discuss the risk factors of this deformity. Five patients (1 man and 4 women) who underwent the simultaneous procedure were examined. Their mean age at surgery was 68.4+/-3.4 years, and the mean follow-up period was 30.8+/-9.5 months. Their underlying diseases were rheumatoid arthritis, and one of them had athetosis, too. On neutral lateral cervical radiographs, tangents were drawn to the inferior endplates of C2 to C5, respectively, and we measured the angles between C2 and C3, C3 and C4, C4 and C5, and C2 and C5 just after surgery and at the latest follow-up. The mean angles were 2.1, -1.9, 1.8, and 1.2 degrees, respectively, just after surgery; and 2.1, -3.5, -2.6, and -5.8 degrees, respectively, at the latest follow-up. Although the mean angle between C2 and 3 hardly changed postoperatively, the mean angle between C2 and C5 significantly decreased postoperatively. In summary, atlantoaxial fixation and cervical expansive laminoplasty may be an unsuitable combination because cervical kyphosis after the simultaneous procedure developed as a complication during the short-term follow-up.

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http://dx.doi.org/10.1097/01.bsd.0000211225.97178.62DOI Listing

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