Evidence map›Paper›PMID 38825607›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024

Cervical kyphosis after posterior cervical laminectomy with and without fusion.

Thorsten Jentzsch, Oliver T Wetzel, Armaan K Malhotra, Christopher S Lozano, Eric M Massicotte, José M Spirig, Michael G Fehlings, Mazda Farshad

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Thorsten Jentzsch *Department of Orthopedics, University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland. thorsten.jentzsch@balgrist.ch.ORCID 0000-0002-6133-3314
Oliver T Wetzel *Department of Orthopedics, University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland. oliver.wetzel@hotmail.com.
Armaan K MalhotraDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
Christopher S LozanoDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
Eric M MassicotteDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
José M SpirigDepartment of Orthopedics, University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Michael G FehlingsDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
Mazda FarshadDepartment of Orthopedics, University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCervical posterior instrumentation and fusion is often performed to avoid post-laminectomy kyphosis. However, larger comparative analyses of cervical laminectomy with or without fusion are sparse.

methodsA retrospective, two-center, comparative cohort study included patients after stand-alone dorsal laminectomy with (n = 91) or without (n = 46) additional fusion for degenerative cervical myelopathy with a median follow-up of 59 (interquartile range (IQR) 52) months. The primary outcome was the C2-7 Cobb angle and secondary outcomes were Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) scale, revision rates, T1 slope and C2-7 sagittal vertical axis (C2-7 SVA) at final follow-up. Logistic regression analysis adjusted for potential confounders (i.e. age, operated levels, and follow-up).

resultsPreoperative C2-7 Cobb angle and T1 slope were higher in the laminectomy group, while the C2-7 SVA was similar. The decrease in C2-7 Cobb angle from pre- to postoperatively was more pronounced in the laminectomy group (- 6° (IQR 20) versus -1° (IQR 7), p = 0.002). When adjusting for confounders, the decrease in C2-7 Cobb angle remained higher in the laminectomy group (coefficient - 12 (95% confidence interval (CI) -18 to -5), p = 0.001). However, there were no adjusted differences for postoperative NDI (- 11 (- 23 to 2), p = 0.10), mJOA, revision rates, T1 slope and C2-7 SVA.

conclusionPosterior cervical laminectomy without fusion is associated with mild loss of cervical lordosis of around 6° in the mid-term after approximately five years, however without any clinical relevance regarding NDI or mJOA in well-selected patients (particularly in shorter segment laminectomies of < 3 levels).

Indexed as

Cervical VertebraeKyphosisLaminectomySpinal FusionAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesSpinal Cord DiseasesTreatment OutcomeLaminectomyMyelopathySpinal cord diseasesSpinal fusionSpine

Identifiers

PMID38825607

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.