{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:23:25Z","timestamp":1787729005860,"version":"build-2784847793"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"\nOBJECTIVE<\/jats:title>\nResidual anterior spinal cord compression (RASCC) after cervical laminoplasty, which has been confirmed on postoperative MRI, is reportedly associated with poor clinical outcomes. To date, only a few studies have described the risk factors associated with RASCC. The aim of this study was to identify the factors that can predict the occurrence of RASCC after laminoplasty for cervical spondylotic myelopathy (CSM), focusing on the location of the most stenotic segment.<\/jats:p>\n<\/jats:sec>\n\nMETHODS<\/jats:title>\nIn this retrospective, single-center study, 120 patients who underwent C3\u20137 laminoplasty for multilevel CSM were included. Different techniques were used for C3 decompression, i.e., partial (dome-laminotomy) or complete (laminoplasty\/laminectomy) decompression. RASCC was diagnosed using MRI conducted 3 weeks postoperatively. The patients were divided into two groups according to the segment with the most severe stenosis (Seg-MSS<\/jats:sub>; C3\u20134 vs C4\u20137). Demographics, radiological data, and C3 decompression technique were compared between the two groups. Furthermore, intergroup comparisons were performed based on Seg-MSS<\/jats:sub>. A logistic regression model was constructed to identify the factors predicting RASCC after patient stratification according to Seg-MSS<\/jats:sub>.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nForty patients (33.3%) had RASCC. The patients with Seg-MSS<\/jats:sub> at C3\u20134 (51.3%) had a significantly higher incidence of RASCC (p = 0.003) than those with Seg-MSS<\/jats:sub> at C4\u20137 (24.7%). Logistic regression analysis showed that in patients with Seg-MSS<\/jats:sub> at C3\u20134, C3 partial decompression demonstrated a greater association with RASCC as opposed to complete decompression. Conversely, in patients with Seg-MSS<\/jats:sub> at C4\u20137, kyphotic segmental lordotic angle was associated with an increased risk of RASCC.<\/jats:p>\n<\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nThe risk factors for RASCC differed depending on the location of the most stenotic segment (C3\u20134 vs C4\u20137). If there is segmental kyphosis at the most stenotic segment at C4\u20137, anterior decompression and fusion should be considered. If C3\u20134 is the most stenotic segment, anterior surgery is also recommended, but alternatively, one can choose laminoplasty with complete C3 laminectomy and resection of the C2\u20133 ligamentum flavum.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.5.spine22168","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T08:59:13Z","timestamp":1657270753000},"page":"794-801","source":"Crossref","is-referenced-by-count":7,"title":["Residual anterior cord compression after laminoplasty for cervical spondylotic myelopathy: evaluation of risk factors according to the most severely stenotic vertebral segment"],"prefix":"10.3171","volume":"37","author":[{"given":"Takayoshi","family":"Shimizu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Fujibayashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bungo","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6 Suppl","key":"b1","series-title":"Spine J","first-page":"274S","article-title":"Cervical laminoplasty","volume":"6","author":"Steinmetz MP","year":"2006","unstructured":"Steinmetz MP, Resnick DK. Cervical laminoplasty. Spine J. 2006;6(6 Suppl):274S\u2013281S.17097547"},{"issue":"7","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"693","article-title":"Expansive open-door laminoplasty for cervical spinal stenotic myelopathy","volume":"8","author":"Hirabayashi K","year":"1983","unstructured":"Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine (Phila Pa 1976). 1983;8(7):693\u2013699.6420895"},{"issue":"6","key":"b3","series-title":"J Bone Joint Surg Br","first-page":"956","article-title":"Long-term follow-up of cervical spondylotic myelopathy treated by canal-expansive laminoplasty","volume":"77","author":"Kimura I","year":"1995","unstructured":"Kimura I, Shingu H, Nasu Y. Long-term follow-up of cervical spondylotic myelopathy treated by canal-expansive laminoplasty. 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Surgical approach to cervical spondylotic myelopathy on the basis of radiological patterns of compression: prospective analysis of 129 cases. Eur Spine J. 2008;17(12):1651\u20131663.18946692"},{"issue":"5","key":"b15","series-title":"Spine (Phila Pa 1976)","first-page":"377","article-title":"Presence of anterior compression of the spinal cord after laminoplasty inhibits upper extremity motor recovery in patients with cervical spondylotic myelopathy","volume":"37","author":"Hirai T","year":"2012","unstructured":"Hirai T, Kawabata S, Enomoto M, Presence of anterior compression of the spinal cord after laminoplasty inhibits upper extremity motor recovery in patients with cervical spondylotic myelopathy. 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