ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1661963
This article is part of the Research TopicClinical and Basic Research on Chronic Spinal Cord Injury Associated with Spinal DegenerationView all 15 articles
The effects of C2 instability on cervical curvature changes and clinical outcomes after sub-axial cervical expansive door-open laminoplasty
Provisionally accepted
- 1The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- 2The Second Affiliated Hospital of the Naval Military Medical University, Shanghai, China
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Objective: To investigate the impact of C2 vertebral instability on the sagittal parameters of the cervical spine and the clinical efficacy after cervical laminoplasty with unilateral open-door cervical expansive laminoplasty (EMOL). Methods: In a retrospective analysis of 18 patients with cervical 2 vertebral instability from August 2017 to August 2021 in the second Affiliated Hospital of Naval Military Medical University and the Six Affiliated Hospital of Xinjiang Medical University treated with single open-door vertebroplasty (C3-6 or C3-7), 36 patients with stable cervical 2 cervical EMOL during the same period (control group). To evaluate the changes in sagittal parameters before and after surgery in the two groups, including C0-2 Cobb angle, C2-7 sagittal axis distance (sagittal vertical axis, SVA), C2-7 Cobb angle, T1 tilt angle (T1-Sl); The postoperative outcome was evaluated using the visual analogue score for neck and shoulder pain (visual analog scale, VAS) and the Japan Society Cervical Function Score (Japanese 0rthopaedic Association, JOA). Results: Compared to preoperative values, both the observation group and the control group showed significant improvement in postoperative VAS scores and JOA scores. The JOA scores were 14.0±1.6 and 13.1±1.6, with improvement rates of 68.42% and 58.06%, respectively, compared to their respective preoperative scores. At the last follow-up, the observation group showed a significant decrease in C2-7 Cobb angle from preoperative (8.2±2.5)° to (5.1±2.5)° (p<0.05). Cervical ROM decreased from preoperative (39.8±3.6)° to (31.6±4.5)° (p<0.05). C0-2 Cobb angle increased from preoperative (22.0±3.7)° to (25.8±3.1)° (p<0.05). C2-7 SVA increased from preoperative (-19.6±3.4)° to (-15.8±3.7)° (p<0.05). However, there was no significant change in T1 slope at the last follow-up (p>0.05). The observation group showed a decrease in C2 vertebral displacement from preoperative (4.5±0.9) mm to (3.3±0.5) mm (p<0.05), while the C2/3 angle showed no significant change compared to preoperative values (p>0.05). In both groups, postoperative follow-up showed a significant increase in C0-2 Cobb angle and C2-7 SVA, a non-significant difference in T1 slope. Conclusion: C2 vertebral instability does not affect the sagittal parameters and efficacy of cervical laminoplasty with EMOL. EMOL surgery for cervical myelopathy with C2 vertebral instability is effective and reliable, without exacerbating C2 vertebral instability.
Keywords: Lower cervical vertebra, Cervical spondylotic myelopathy, Single door enlarged spinal canal plasty, Sagittal plane balance, Cervical instability
Received: 08 Jul 2025; Accepted: 03 Oct 2025.
Copyright: © 2025 Ma, Liu, Xi, Shi and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Changgui Shi, charlieshi@smmu.edu.cn
Xiangyu Meng, 1016568047@qq.com
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