Abstract
Objective: Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods: Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results: Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion: To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.
| Original language | English |
|---|---|
| Pages (from-to) | 368-373 |
| Number of pages | 6 |
| Journal | Journal of Korean Neurosurgical Society |
| Volume | 59 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2016 Jan 1 |
Fingerprint
Keywords
- Cervical
- Fracture
- Hinge
- Lamina
- Laminoplasty
- Risk factors
ASJC Scopus subject areas
- Surgery
- Neuroscience(all)
- Clinical Neurology
Cite this
Risk factors for delayed hinge fracture after plate-augmented cervical open-door laminoplasty. / Hur, Junseok W.; Park, Youn-Kwan; Kim, Bum-Joon; Moon, Hong Joo; Kim, Joo-Han.
In: Journal of Korean Neurosurgical Society, Vol. 59, No. 4, 01.01.2016, p. 368-373.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk factors for delayed hinge fracture after plate-augmented cervical open-door laminoplasty
AU - Hur, Junseok W.
AU - Park, Youn-Kwan
AU - Kim, Bum-Joon
AU - Moon, Hong Joo
AU - Kim, Joo-Han
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Objective: Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods: Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results: Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion: To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.
AB - Objective: Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods: Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results: Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion: To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.
KW - Cervical
KW - Fracture
KW - Hinge
KW - Lamina
KW - Laminoplasty
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=84978689393&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978689393&partnerID=8YFLogxK
U2 - 10.3340/jkns.2016.59.4.368
DO - 10.3340/jkns.2016.59.4.368
M3 - Article
AN - SCOPUS:84978689393
VL - 59
SP - 368
EP - 373
JO - Journal of Korean Neurosurgical Society
JF - Journal of Korean Neurosurgical Society
SN - 2005-3711
IS - 4
ER -