The effect of minimally invasive dorsal cervical decompression for myelopathy on spinal alignment and range of motion

Abstract

ObjectiveMinimally invasive dorsal cervical decompression (miDCD) has been reported as a novel alternative to open dorsal decompression techniques such as laminectomy, laminoplasty, or laminectomy and fusion. Only limited data have been presented regarding the effects of a minimally invasive approach on cervical motion and alignment. The object of the current study is to provide a more comprehensive analysis of radiographic outcomes following miDCD. Patients and MethodsThirty-five patients who had undergone miDCD for myelopathy were included. Exclusion criteria included prior cervical spine surgery, prior cervical spine fracture, fusion of the cervical spine during miDCD, and/or acute spinal cord injury. Analysis of x-rays included the following data elements: degrees of flexion, degrees of extension, and total range of motion; C2-C7 angle as a measure of cervical lordosis; C2-C7 sagittal vertical axis; effective lordosis; and C7 slope. Patient reported outcome measures included neck Visual Analog Score (VAS), Neck Disability Index (NDI), SF-12 Physical Component Score (PCS), SF-12 Mental Component Score (MCS), Nurick score, and modified Japanese Orthopedic Association Myelopathy scale (mJOA). ResultsPre-operative to post-operative comparisons of all radiographic parameters – including total range of motion, C2-C7 Cobb angle, C2-C7 sagittal vertical axis, effective lordosis, and C7 slope angle – remained stable. Several clinical outcomes demonstrated statistical improvement, namely neck VAS, Nurick score, mJOA, NDI, and SF-12 PCS. ConclusionsmiDCD can maintain cervical range of motion and alignment better than traditional laminectomy or laminoplasty techniques.