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  • Title: Prediction of incomplete decompression after cervical laminoplasty on magnetic resonance imaging: The modified K-line.
    Author: Sun LQ, Li M, Li YM.
    Journal: Clin Neurol Neurosurg; 2016 Jul; 146():12-7. PubMed ID: 27132078.
    Abstract:
    OBJECTIVES: The original K-line was developed on plain radiograph to predict incomplete indirect decompression for the patients with ossification of the posterior longitudinal ligament. The current study modified the K-line on magnetic resonance imaging (MRI) to determine risk factors for incomplete decompression after laminoplasty and to provide a guide for predicting incomplete decompression after laminoplasty and making decisions regarding the surgical approach in patients with cervical spondylotic myelopathy (CSM). PATIENTS AND METHODS: A retrospective review of 47 patients with CSM after laminoplasty was conducted. The modified K-line was defined as a line connecting both anterior points of the spinal cord at the level of the inferior vertebrae endplates of C2 and C7 on sagittal T1-weighted MR image. Quantitative analysis of the interval between the maximal anterior compression factor and the modified K-line (IAK) was performed to investigate the efficiency and practicality of this modified K-line. Data analysis involved logistic regression and Spearman rank correlation coefficient. RESULTS: Thirteen patients (27.7%) had postoperative residual anterior compression of the spinal cord (ACS). Univariate logistic regression with backward stepwise procedure showed that only IAK (odds ratio: 0.301; 95% confidence interval: 0.134-0.673, P=0.003) was a significant risk factor for the occurrence of postoperative ACS. Incidence of ACS was 80% in patients with an IAK of less than 1.5mm and 96.2% in those whose IAK is 0mm. CONCLUSION: The modified k-line can provide a guide for predicting poor clinical outcome after laminoplasty and making decisions regarding the surgical approach in patients with CSM.
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