Predictors of poor outcome in cervical spondylotic myelopathy patients underwent anterior hybrid approach: focusing on c
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(2020) 15:369
RESEARCH ARTICLE
Open Access
Predictors of poor outcome in cervical spondylotic myelopathy patients underwent anterior hybrid approach: focusing on change of local kyphosis Xing Jian Cheng1, Lin Jin2, Xin Wang3, Wen Zhang1 and Yong Shen1*
Abstract Objective: This study was a retrospective multivariable analysis for risk factors of poor outcome in patients who underwent anterior hybrid approach, and discussed the causes of worsening of postoperative local alignment. Methods: A total of 86 patients with progressive spinal cord compression and local kyphosis underwent an anterior hybrid approach (ACDF+ACCF), between June 2011 and June 2017. We evaluated clinical outcome by the Japanese Orthopaedic Association (JOA) score and recovery rate. Patients were divided into two groups according to the worsening and improving of postoperative local alignment. Multivariate logistic regression analysis was applied to the evaluation of risk factors. Mann-Whitney U test, independent t test, and chi-squared test were performed for the comparison of local kyphosis between postoperative and last follow-up. Results: There were twenty patients who had a recovery rate of less than 50%. Advance age, longer duration of symptoms, bigger T1 slope angle, and lower change of local kyphosis angle were significantly associated with a poor clinical outcome by multivariate logistic regression analysis. The cause of worsening of postoperative local alignment had T1 slope, C2–7 sagittal vertical axis (SVA), adjacent segment degeneration (ASD), and implant subsidence. Conclusions: The change of local kyphosis was a predictor of clinical outcome after the hybrid approach. Furthermore, postoperative ASD, implant subsidence, T1 slope, and C2–7 Cobb were associated with recurrence of postoperative cervical kyphosis. Keywords: Cervical spondylotic myelopathy, Local kyphosis, Hybrid approach, T1 slope angle, Postoperative outcome
* Correspondence: [email protected] 1 Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Com
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