{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:36:36Z","timestamp":1789799796389,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Recently, the MRI\u2010based cervical vertebral bone quality (C\u2010VBQ) scoring system has demonstrated accuracy in reflecting cervical bone quality and predicting postoperative complications from cervical spine surgery. Studies have shown that cervical bone quality is closely linked to loss of cervical lordosis (LCL) after open\u2010door laminoplasty. Additionally, research on lumbar VBQ indicates a strong correlation between lumbar VBQ scores and lumbar paraspinal muscle quality. However, the relationship of C\u2010VBQ score to cervical paraspinal muscles and LCL remains unclear. Therefore, this study aimed to explore the relationship between C\u2010VBQ score and cervical paraspinal muscle\u2010related parameters as well as postoperative LCL, in addition to exploring the risk factors associated with LCL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 101 patients who underwent standard C3\u2013C7 open\u2010door laminoplasty at our institution from 2012 to 2022 were included in this study. The LCL group was defined as loss of cervical lordosis &gt;\u20095\u00b0 at 1\u2010year postoperative follow\u2010up. Cervical X\u2010rays were obtained to measure the C2\u20137 Cobb angle, C2\u20137 sagittal vertical axis (SVA), T1 slope, and cervical range of motion (ROM). The relative cross\u2010sectional area (RCSA) and degree of fat infiltration (DFF) of the deep cervical extensors, flexors, and all muscles were measured using image J software. Cervical CT Hounsfield unit (HU) and C\u2010VBQ values were measured on preoperative CT and MRI T1\u2010weighted mid\u2010sagittal images, respectively. Then, demographics, cervical sagittal parameters, ROM, paraspinal muscle\u2010related parameters, CT\u2010HU and C\u2010VBQ values were assessed for their correlation with LCL, and multivariate linear analysis was used to determine the risk factors associated with LCL. Finally, the relationship between C\u2010VBQ scores and cervical paraspinal muscle\u2010related parameters was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 55 (54.45%) patients were included in the LCL group due to loss of cervical lordosis &gt;\u20095\u00b0 at 1\u2010year follow\u2010up. LCL was positively correlated to the preoperative T1 slope, Flexion ROM, C2\u20137 ROM, Flexion\/Extension ROM, Flexion muscles DFF, Extension muscles DFF, Average DFF, and C\u2010VBQ scores, while it was negatively correlated to Extension ROM, Extension muscles RCSA, Total RCSA, and CT\u2010HU values. Furthermore, Flexion\/Extension ROM, Total RCSA, Average DFF, CT\u2010HU, and C\u2010VBQ values were independent risk factors for LCL. In addition, C\u2010VBQ scores were significantly correlated with RCSA and DFF of Flexion and Extension muscles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study is the first to find a significant correlation between C\u2010VBQ scores and cervical paraspinal muscle quality. The C\u2010VBQ score is a comprehensive indicator that reflects the quality of the cervical bone and paravertebral muscles, and it is a novel predictor of LCL after open\u2010door laminoplasty.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70028","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T09:37:47Z","timestamp":1742377067000},"page":"1406-1417","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Cervical Vertebral Bone Quality Score Is a Novel Reliable Index Reflecting the Condition of Paraspinal Muscles and Predicting Loss of Cervical Lordosis After Open\u2010Door Laminoplasty"],"prefix":"10.1111","volume":"17","author":[{"given":"Junhu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital and West China School of Medicine Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingxia","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, West China Hospital and West China School of Nursing Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linnan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital and West China School of Medicine Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3331-3674","authenticated-orcid":false,"given":"Qiujiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital and West China School of Medicine Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2612-8657","authenticated-orcid":false,"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital and West China School of Medicine Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueming","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital and West China School of Medicine Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198310000-00003"},{"key":"e_1_2_13_3_1","first-page":"1743","article-title":"Curvature and Range of Motion of the Cervical Spine After Laminaplasty","volume":"82","author":"Aita I.","year":"2000","journal-title":"Journal of Bone and Joint Surgery. 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