Accuracy of Realigned K-line for Predicting Surgical Outcomes After Laminoplasty in Patients With Degenerative Cervical Myelopathy

Author:

Duan Qifei12ORCID,Liang Guoyan2,Chen Chong2,Ye Yongyu2,Zheng Xiaoqing2,Liang Changxiang2,Chang Yunbing12

Affiliation:

1. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China

2. Department of Spine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

Abstract

Study Design A prospective cohort study. Objectives To report a new index, the realigned K-line, for predicting surgical outcomes after laminoplasty in patients with degenerative cervical myelopathy (DCM). Methods One hundred twenty-eight patients with DCM undergoing laminoplasty were enrolled from January 2018 to April 2021 in our department. A realigned K-line was defined as the line connecting the midpoints of the spinal cord between C2 and C7 on realigned T1-weighted magnetic resonance imaging. The minimum interval between the anterior compression factors of the spinal cord and the realigned K-line (INTrea), and the modified K-line (INTmod) were measured. A logistic regression analysis was performed to identify factors associated with unsatisfactory surgical outcomes. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) was applied to evaluate the reliability of the multivariate logistic regression model. Results Univariate analysis showed that the score for the bladder function section of the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire, numeric rating scale scores for arm pain, and INTrea might be related to the Japanese Orthopaedic Association (JOA) recovery rate (RR) not achieving the minimal clinically important difference (MCID) (P < .05). Only INTrea (odds ratio = .744, P < .05) was an independent preoperative factor related to the JOA RR not achieving the MCID (area under the curve, .743). A cutoff of 5.0 mm for INTrea had an accuracy of 71.9% and specificity of 80.3% for predicting the JOA RR not achieving the MCID. Conclusions INTrea is an independent preoperative risk factor related to the JOA RR not achieving the MCID in patients with DCM. A cutoff point of 5.0 mm is most appropriate for alerting spine surgeons to a high likelihood of the JOA RR not achieving the MCID.

Funder

Natural Science Foundation of Guangdong Province

Guangzhou Science and Technology Program Key Projects

National Natural Science Foundation of China

Basic and Applied Basic Research Foundation of Guangdong Province

Guangdong Provincial Traditional Chinese Medicine Research Project

Guangdong Medical Research Foundation

Publisher

SAGE Publications

Subject

Neurology (clinical),Orthopedics and Sports Medicine,Surgery

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