Cervical Sagittal Imbalance after Cervical Laminoplasty in Elderly Patients

Abstract

Background Context. Cervical laminoplasty often gives rise to cervical sagittal imbalance attributable to injury of posterior structures including laminae, articular facets, muscles, and ligaments. Purpose. To determine the effect of age on sagittal cervical alignment after cervical laminoplasty procedure so as to identify the group with the greatest degree of variation. Study Setting. Single-center retrospective chart review in a tertiary referral hospital. Outcome Measures. The sagittal vertical axis (SVA) (C2-7), T1 slope, and cervical lordosis. Methods. We included patients who underwent cervical laminoplasty between 2014 and 2018 and divided 60 consecutive patients into two groups using the cut-off age of 65 years. The Paired $t$ -test and Mann-Whitney $U$ test were used to compare changes between preoperative radiographic cervical sagittal parameters and those 1 year after surgery. Results. Mean patient ages in the older and younger groups were 71 years and 52 years, respectively. The difference of C2-7 SVA was greater in the older group. Conclusion. Postoperative cervical balance can be worse when laminoplasty is performed in elderly patients.