Impact of Preoperative Cervical Listhesis on Outcomes Following Unilateral Open-Door Cervical Laminoplasty.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-07-14 DOI:10.1097/BSD.0000000000001879

Alejandro Perez-Albela, Charles Furlong, Ishan Shah, Timothy Jeng, Samuel Bara, Bryce A Basques

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引用次数: 0

Abstract

Study design: Retrospective cohort study.

Objective: To evaluate the impact of preoperative cervical spondylolisthesis, defined as ≥2 mm of translation at any cervical level, on postoperative outcomes following unilateral open-door cervical laminoplasty.

Background: Cervical laminoplasty is a motion-preserving procedure for cervical spondylotic myelopathy (CSM). The effect of preoperative cervical listhesis on laminoplasty outcomes remains unclear, with mixed findings in the literature regarding its influence on pain relief, alignment, and complications.

Materials and methods: We retrospectively reviewed 104 patients who underwent unilateral open-door laminoplasty for CSM from 2017 to 2023 with at least 1 year of follow-up. Patients were grouped by presence (n = 43) or absence (n = 61) of preoperative listhesis. Demographics, radiographic parameters [eg, Torg-Pavlov ratio (TPR), C2 to C7 Cobb angle], and clinical outcomes (eg, VAS scores, complications) were compared. Multivariate logistic regression was used to assess whether listhesis predicted adverse outcomes.

Results: Both groups experienced significant postoperative VAS improvement, with no differences in pain relief, reoperation rates, hardware complications, or sagittal alignment. The listhesis group had a lower TPR (0.70 ± 0.112) than the no listhesis group (0.76 ± 0.115, P = 0.0043). Listhesis progression was minimal and not significant. At 1 year, there were no significant differences in reoperation (9.8% vs 2.3%, P = 0.132), screw backout (8.2% vs 0%, P = 0.054), or loss of lordosis ≥10 degrees (34.4% vs 39.5%, P = 0.594). Preoperative listhesis was not a predictor of adverse outcomes on multivariate analysis.

Conclusions: Preoperative cervical listhesis was not associated with inferior outcomes following unilateral open-door laminoplasty. Both groups showed comparable improvements in pain and maintained spinal alignment, suggesting that mild to moderate listhesis may not be a significant determinant of surgical outcomes in this population.

Level of evidence: Level III.

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术前颈椎滑脱对单侧开门颈椎椎板成形术疗效的影响。

研究设计：回顾性队列研究。目的：评估术前颈椎滑脱（定义为在任何颈椎水平移位≥2mm）对单侧开放式颈椎板成形术术后结果的影响。背景：颈椎板成形术是治疗脊髓型颈椎病（CSM）的一种运动保持手术。术前颈椎滑脱对椎板成形术结果的影响尚不清楚，文献中关于其对疼痛缓解、对齐和并发症的影响的研究结果不一。材料和方法：我们回顾性分析了2017年至2023年接受单侧开门椎板成形术治疗CSM的104例患者，随访至少1年。患者按术前有脱位（n = 43）或无脱位（n = 61）进行分组。比较人口统计学、影像学参数[如TPR、C2 / C7 Cobb角]和临床结果（如VAS评分、并发症）。多变量逻辑回归用于评估滑脱是否预测不良结局。结果：两组术后VAS均有显著改善，在疼痛缓解、再手术率、硬件并发症或矢状面对齐方面无差异。脱体组TPR（0.70±0.112）低于未脱体组（0.76±0.115,P = 0.0043）。脱位进展最小且不显著。1年后，两组再手术（9.8% vs 2.3%, P = 0.132）、螺钉退出（8.2% vs 0%, P = 0.054）或前凸≥10度丧失（34.4% vs 39.5%, P = 0.594）均无显著差异。在多变量分析中，术前滑脱不是不良结果的预测因子。结论：术前颈椎滑脱与单侧开门椎板成形术后的不良预后无关。两组在疼痛和脊柱对齐方面均有相当程度的改善，提示轻度至中度脱位可能不是该人群手术结果的重要决定因素。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.