Deep Neck Extensors [Neurosurgery Wiki]

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====== Deep Neck Extensors ======

Deep Neck Extensors: The deep cervical extensors (semispinalis cevicis, multifidus, and rotators) along with the cranio-cervical extensors (rectus capitis posterior major/minor and obliquus capitis superior/inferior) are KEY MUSCLES for cervical spine segmental support due to their relatively small moment arms.
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The objective of a study by Liu et al. was to investigate the association between the [[cross-sectional area]] (CSA) of the deep extensor [[muscle]]s (DEM) and post[[laminoplasty]] alignment.

The preoperative CSA of the [[Semispinalis cervicis muscle]] (SC) has been reported to correlate with [[loss of lordosis]] (LL) after [[laminoplasty,]] with a CSA <154.5 mm2 associated with a 10 degrees LL.

Laminoplasty patients at the University of [[California]] [[San Francisco]] between 2009 and 2018 by 2 [[spine surgeon]]s were retrospectively studied. Patients with previous [[cervical spine surgery]] or nondegenerative diagnoses were excluded. Measurements included the [[C2-C7 angle]], [[T1 slope]], and [[cervical]] [[sagittal vertical axis]]. Preoperative DEM CSA was measured on [[magnetic resonance imaging]]. Variables associated with lordosis were analyzed with [[univariate]] analysis and multivariate [[logistic regression]], and association between postoperative [[Cervical spine alignment]] and the musculature was evaluated.

Seventy-six patients with a mean age of 64 years were included. The average follow-up was 22.53 months. The overall average CSA of the DEM was 2274.55 mm2 and that of the SC was 275.64 mm2. Means of both CSAs were higher in men (P<0.001). Linear regression showed no correlation between LL with CSA of the DEM or the SC (r=0.005, P=0.119; r=0.001, P=0.095). Univariate and multivariate regression showed no differences in the CSA of the DEM and SC between groups with and without LL (P=0.092, 0.117 and 0.163, 0.292). There was no correlation in LL with sex or body mass index (P>0.05).

Preoperative CSA of the [[deep neck extensors]] may not predict [[lordosis]] after [[cervical laminoplasty]]. The correlation between the preoperative SC CSA and postoperative [[Cervical spine alignment]] may not be as strong as previously reported
((Liu J, Xie R, Ruan H, Rivera J, Li B, Mahmood B, Lee J, Guizar R 3rd, Mahmoudieh Y, Mummaneni PV, Chou D. The [[Preoperative]] [[Cross-sectional Area]] of the Deep Cervical Extensor Muscles Does Not Predict Loss of [[Lordosis]] After Cervical Laminoplasty. Clin Spine Surg. 2021 May 24. doi: 10.1097/BSD.0000000000001199. Epub ahead of print. PMID: 34029263.)).