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Journals / Acta Orthopaedica et Traumatologica Turcica / 2022 / Cilt: 56 - Sayı: 2

The effect of disruption of the repaired nuchal ligament on clinical outcomes after posterior cervical spine surgery: A retrospective comparative study

Kazunari Takeuchi
Toru Yokoyama
Taku Fujita
Kanichiro Wada
Gentaro Kumagai
Yasuyuki Ishibashi
Pages
131–137
Publication Date
2022-10-10
DOI
—
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Conclusion: Evidence from this study has shown that postoperative disruption of the repaired NL has no significant effect on postopera- tive axial symptoms and C2-C7 alignment, but it can affect the rate of decrease in C2-C7 ROM after LP

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: This study aimed to investigate whether disruption of the repaired nuchal ligament (NL) affects clinical outcomes following posterior cervical spine surgery.
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Key Findings & Data:Methods: This retrospective study included 101 patients (65 males, 36 females) who underwent posterior cervical spine surgery, 69 of whom received laminoplasty (LP), and 32 posterior decompression and fusion (PDF).
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Conclusion & Impact:Conclusion: Evidence from this study has shown that postoperative disruption of the repaired NL has no significant effect on postopera- tive axial symptoms and C2-C7 alignment, but it can affect the rate of decrease in C2-C7 ROM after LP
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: This study aimed to investigate whether disruption of the repaired nuchal ligament (NL) affects clinical outcomes following posterior cervical spine surgery. Methods: This retrospective study included 101 patients (65 males, 36 females) who underwent posterior cervical spine surgery, 69 of whom received laminoplasty (LP), and 32 posterior decompression and fusion (PDF). The NL was split during the surgical approach and repaired at the time of wound closure. The frequency and spinal levels of NL disruption at one month, six months, and one year post- operatively were evaluated on mid-sagittal and axial magnetic resonance images. Postoperative axial symptoms, Neck Disability Index, T1 slope, flexion and extension angle, C2-C7 lordotic angle, and decrease rate of C2-C7 range of motion (ROM) were examined at six months and/or one year postoperatively. Based on the NL disruption levels, the patients were divided into the upper group (C2-C5), lower group (C6-T1), and non-disruption group. Results: Although the lower group contained patients with NL disruption (10%) after LP at final follow-up, all PDF patients belonged to the non-disruption group. For the LP patients, the postoperative axial symptoms, Neck Disability Index, T1 slope, flexion and extension angle, and C2-C7 lordotic angle did not significantly differ between the lower and non-disruption groups; however, the rate of C2-C7 ROM decrease in the lower group (48%) was considerably larger than that in the non-disruption group (33%) after LP. Conclusion: Evidence from this study has shown that postoperative disruption of the repaired NL has no significant effect on postopera- tive axial symptoms and C2-C7 alignment, but it can affect the rate of decrease in C2-C7 ROM after LP

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Cite This Article

Takeuchi, K., Yokoyama, T., Fujita, T., Wada, K., Kumagai, G., Ishibashi, Y. (2022). The effect of disruption of the repaired nuchal ligament on clinical outcomes after posterior cervical spine surgery: A retrospective comparative study. Acta Orthopaedica et Traumatologica Turcica, Cilt: 56 - Sayı: 2, 131–137. https://ajindex.com/articles/427952

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References (11)

  1. Yoshida M, Tamaki T, Kawakami M, et al. Does reconstruction of posterior liga- mentous complex with extensor musculature decrease axial symptoms after cervical laminoplasty? Spine. 2002
  2. 27(13):1414-1418. [CrossRef] 2. Tsuzuki N, Abe R, Saiki K, Iizuka T. Tension-band laminoplasty of the cervical spine. Int Orthop. 1996
  3. 20(5):275-284. [CrossRef] 3. Sakaura H, Hosono N, Mukai Y, Oshima K, Iwasaki M, Yoshikawa H. Preserva- tion of the nuchal ligament plays an important role in preventing unfavorable radiologic changes after laminoplasty. J Spinal Disord Tech. 2008
  4. 21(5):338-343. [CrossRef] 4. Hosono N, Sakaura H, Mukai Y, Yoshikawa H. The source of axial pain after cervical laminoplasty-C7 is more crucial than deep extensor muscles. Spine. 2007
  5. 32(26):2985-2988. [CrossRef] 5. Johnson GM, Zhang M, Jones DG. The fine connective tissue architecture of the human ligamentum nuchae. Spine. 2000
  6. 25(1):5-9. [CrossRef] 6. Ono A, Tonosaki Y, Numasawa T, et al. The relationship between the anatomy of the NL and postoperative axial pain after cervical laminoplasty: cadaver and clinical study. Spine. 2012
  7. 15(37(26)):E1607-E1613. 7. Takeshita K, Peterson ET, Bylski-Austrow D, Crawford AH, Nakamura K. The nuchal ligament restrains cervical spine flexion. Spine. 2004
  8. 29(18):E388-E393. [CrossRef] 8. Takeuchi K, Yokoyama T, Numasawa T, et al. K-line (-) in the neck-flexed posi- tion in patients with ossification of the posterior longitudinal ligament is a risk factor for poor clinical outcome after cervical laminoplasty. Spine. 2016
  9. 41(24):1891- 1895. [CrossRef] 9. Tani T, Ushida T, Taniguchi S, Ishida K, Tsuboya H, Ikemoto T. Partial conduc- tion block in cervical compression myelopathies: waveform changes of ascend- ing spinal evoked potentials. Chapter 35. Functional Neuroscience: Evoked Potentials and Related Techniques. Selected Presentations from the 8the Inter- national Evoked Potentials Symposium (Fukuoka, Japan). Supplements to Clini- cal Neurophysiology. Amsterdam: Elsevier
  10. Takeuchi K, Yokoyama T, Wada KI, Kudo H. Relationship between enlargement of the cross-sectional area of the dural sac and neurological improvements after cervical laminoplasty: differences between cervical spondylotic myelopa- thy and ossification of the posterior longitudinal ligament. Spine Surg Relat Res. 2019
  11. 3(1):27-36. [CrossRef] 11. Takeuchi K, Yokoyama T, Aburakawa S, et al. Axial symptoms after cervical laminoplasty with C3 laminectomy compared with conventional C3-