{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:28:10Z","timestamp":1761805690662,"version":"build-2065373602"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82202436"],"award-info":[{"award-number":["82202436"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science and Technology Projects in Jiangsu Province","award":["BE2023742"],"award-info":[{"award-number":["BE2023742"]}]},{"name":"Research project of Nantong Health Commission","award":["MA2021016"],"award-info":[{"award-number":["MA2021016"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Laminoplasty (LAMP) is a common procedure for multilevel cervical spondylotic myelopathy (MCSM). The traditional K-line is a guide for LAMP candidate selection but is inferior to the modified K-line (mK-line) in predicting clinical outcomes. The spinal cord line (SC-line) is another indicator that considers anterior compression but is not typically used for selecting surgical segments. This study intended to propose and validate the combined application of modified spinal cord line (mSC-line) with mK-line for surgical decision-making in MCSM patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 63 MCSM patients categorized into K-line(\u2212) group and K-line(+) group, or Type I group and Type II group based on SC-line. We defined mK-line and mSC-line in sagittal T2WI MRIs. All patients with both mK-line(+) and mSC-line(+) underwent standard LAMP. Radiographic analysis was conducted using CCI, mK-INT and mSC-INT. Clinical outcomes were evaluated by JOA, NDI and VAS scores. Preoperative and postoperative radiological outcomes and clinical outcomes were used to evaluate the prognosis and the efficacy of segmental decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were no difference in baseline characteristics among all the participants. Post-operative spinal cord shift indicators (mK-INT and mSC-INT) increased significantly. The JOA score increased, while NDI and VAS scores decreased. Both the radiological outcomes and clinical outcomes demonstrated a good prognosis even in K-line(\u2212) group and Type II group. There was a statistical correlation between JOA score recovery rate with both mK-INT and mSC-INT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The presence of mK-line(+) and mSC-line(+) in MRI is crucial for the selection of surgical segments in LAMP for MCSM patients. This combined criterion can help predict sufficient decompression of the cervical spinal cord and good clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1681524","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:23:08Z","timestamp":1761805388000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of mK-line and mSC-line in segments choice for laminoplasty of multilevel cervical spondylotic myelopathy"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhiming","family":"Cui","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanhua","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinlong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weidong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongxiang","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunshuai","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.wneu.2024.08.089","article-title":"Current status and trends of research on cervical spondylotic myelopathy from the perspective of bibliometrics","volume":"191","author":"Liu","year":"2024","journal-title":"World Neurosurg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"299","DOI":"10.3171\/2019.5.SPINE18769","article-title":"Recent advances in the management of cervical spondylotic myelopathy: bibliometric analysis and surgical perspectives","volume":"31","author":"Chen","year":"2019","journal-title":"J Neurosurg Spine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1097\/BRS.0000000000004814","article-title":"Quantitative romberg on a force plate: objective assessment before and after surgery for cervical spondylotic myelopathy","volume":"49","author":"Kesler","year":"2024","journal-title":"Spine (Phila Pa 1976)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1029327","DOI":"10.3389\/fnins.2022.1029327","article-title":"Cervical alignment and clinical outcome of anterior decompression with fusion vs. posterior decompression with fixation in kyphotic cervical spondylotic myelopathy","volume":"16","author":"Du","year":"2022","journal-title":"Front Neurosci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3017","DOI":"10.1007\/s00586-024-08316-4","article-title":"Correlation between axial symptoms and cervical sagittal alignment parameters in patients with two-level or three-level cervical spondylotic myelopathy: anterior cervcial discectomy and fusion versus hybird surgery","volume":"33","author":"Qiu","year":"2024","journal-title":"Eur Spine J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1227\/neu.0000000000003299","article-title":"Comparative analysis of outcomes and kyphotic risk factors after cervical laminoplasty in 2 different ossification of the posterior longitudinal ligament groups and cervical spondylotic myelopathy","volume":"92","author":"Mun","year":"2024","journal-title":"Neurosurgery"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1016\/j.spinee.2025.03.027","article-title":"Comparison of outcomes after anterior versus posterior surgery for degenerative cervical myelopathy: a pooled analysis of individual patient data","volume":"25","author":"Bak","year":"2025","journal-title":"Spine J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2054","DOI":"10.4103\/0366-6999.161363","article-title":"Comparison of functional and radiological outcomes between two posterior approaches in the treatment of multilevel cervical spondylotic myelopathy","volume":"128","author":"Ren","year":"2015","journal-title":"Chin Med J (Engl)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.spinee.2020.10.021","article-title":"Laminoplasty-an underutilized procedure for cervical spondylotic myelopathy","volume":"21","author":"Lopez","year":"2021","journal-title":"Spine J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"205","DOI":"10.14444\/8028","article-title":"Spinal cord drift following laminoplasty versus laminectomy and fusion for cervical spondylotic myelopathy","volume":"15","author":"Ashana","year":"2021","journal-title":"Int J Spine Surg"},{"key":"B11","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/00002517-199708000-00002","article-title":"Dorsal shift and expansion of the spinal cord after expansive open-door laminoplasty","volume":"10","author":"Fujimura","year":"1997","journal-title":"J Spinal Disord"},{"key":"B12","doi-asserted-by":"publisher","first-page":"E990","DOI":"10.1097\/BRS.0b013e318188b300","article-title":"A new concept for making decisions regarding the surgical approach for cervical ossification of the posterior longitudinal ligament: the K-line","volume":"33","author":"Fujiyoshi","year":"2008","journal-title":"Spine (Phila Pa 1976)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s12891-023-06214-2","article-title":"Usefulness of K-line in predicting prognosis of laminoplasty for cervical spondylotic myelopathy","volume":"24","author":"Ikeda","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"B14","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1016\/j.jos.2021.02.005","article-title":"K-line (\u2212) in the neck-flexed position negatively affects surgical outcome of expansive open-door laminoplasty for cervical spondylotic myelopathy","volume":"27","author":"Nori","year":"2022","journal-title":"J Orthop Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.clineuro.2016.04.013","article-title":"Prediction of incomplete decompression after cervical laminoplasty on magnetic resonance imaging: the modified K-line","volume":"146","author":"Sun","year":"2016","journal-title":"Clin Neurol Neurosurg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1097\/BRS.0b013e318273a4f7","article-title":"Modified K-line in magnetic resonance imaging predicts insufficient decompression of cervical laminoplasty","volume":"38","author":"Taniyama","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.wneu.2017.03.105","article-title":"The spinal cord line can predict postoperative recovery for multilevel cervical spondylotic myelopathy","volume":"104","author":"Tong","year":"2017","journal-title":"World Neurosurg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"E529","DOI":"10.1097\/BSD.0000000000001634","article-title":"A comparison of clinical outcomes between anterior cervical discectomy and fusion versus posterior cervical laminoplasty for multilevel cervical myelopathy","volume":"37","author":"Lee","year":"2024","journal-title":"Clin Spine Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"E882","DOI":"10.1097\/BRS.0000000000003016","article-title":"Sagittal alignment outcomes in lordotic cervical spine: does three-level anterior cervical discectomy and fusion outperform laminoplasty?","volume":"44","author":"Liang","year":"2019","journal-title":"Spine (Phila Pa 1976)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e258","DOI":"10.1016\/j.wneu.2023.09.049","article-title":"Perioperative complications and radiographic outcomes following cervical laminoplasty: a review of 105 cases from a single academic center","volume":"180","author":"Liu","year":"2023","journal-title":"World Neurosurg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"E1302","DOI":"10.1097\/BRS.0000000000003574","article-title":"Intra- and post-complications of cervical laminoplasty for the treatment of cervical myelopathy: an analysis of a nationwide database","volume":"45","author":"Mesregah","year":"2020","journal-title":"Spine (Phila Pa 1976)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/BSD.0000000000000899","article-title":"Is modified K-line a powerful tool of surgical decision making for patients with cervical spondylotic myelopathy?","volume":"32","author":"Hirai","year":"2019","journal-title":"Clin Spine Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"E1031","DOI":"10.1097\/BRS.0000000000003982","article-title":"Modified K-line in neck extension is a prognostic indicator of the surgical outcome at 5 years after cervical laminoplasty for cervical spondylotic myelopathy","volume":"46","author":"Takeuchi","year":"2021","journal-title":"Spine (Phila Pa 1976)"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1681524\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:23:09Z","timestamp":1761805389000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1681524\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":23,"alternative-id":["10.3389\/fsurg.2025.1681524"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1681524","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"article-number":"1681524"}}