Analyses of effect factors associated with the postoperative dissatisfaction of patients undergoing open-door laminoplasty for cervical OPLL: a retrospective cohort study

Liu, Sen; Yang, Sidong; Fan, Xi-Wen; Yang, Dalong; Ma, Lei; Sun, Jing; Ding, Wenyuan

doi:10.1186/s13018-019-1208-8

Cited by 11 publications

(7 citation statements)

References 30 publications

(24 reference statements)

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“…Kawaguchi et al 20 noted that poor recovery postoperatively was associated with kyphotic change of the cervical alignment and spinal cord signal intensity change on T2 weighted magnetic resonance imaging. Similarly, Liu et al 21 observed that patient dissatisfaction at long-term follow-up was associated with low improvement rate of JOA score and symptom recurrence. Therefore, several radiographic and clinical factors might be associated with surgical outcomes in c-OPLL patients.…”

Section: Discussionmentioning

confidence: 87%

Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament

Miyagi

Inoue

Yoshii

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: A prospective multi-institutional observational study. Objective: To investigate and identify risk factors for residual neuropathic pain after surgery in patients with cervical ossification of posterior longitudinal ligament (c-OPLL). Summary of Background Data: Patients with c-OPLL often require surgery for numbness and paralysis of the extremities; however, postoperative neuropathic pain can considerably deteriorate their quality of life. Methods: Out of 479 patients identified from multicenter c-OPLL registries between 2014 and 2017, 292 patients who could be followed up for 2 years postoperatively were reviewed, after excluding patients with nervous system comorbidities. Demographic details; medical history; radiographic factors including the K-line, spinal canal occupancy rate of OPLL, cervical kyphosis angle, and presence of spinal cord myelomalacia; preoperative Japanese Orthopaedic Association (JOA) score; surgical procedure (fusion or decompression surgery); postoperative neurological deterioration; and the visual analogue scale for pain and numbness in the upper extremities (U/E) or trunk/lower extremities (L/E) at baseline and at 2 years postoperatively were assessed. Patients were grouped into residual and non-residual groups based on a postoperative visual analogue scale ≥40 mm. Risk factors for residual neuropathic pain were evaluated by multiple logistic regression analysis. Results: The prevalence of U/E and L/E residual pain in postoperative c-OPLL patients was 51.7% and 40.4%, respectively. The U/E residual group had a poor preoperative JOA score and longer illness duration, and fusion surgery was more common in the residual group than in non-residual group. The L/E residual group was older with a poorer preoperative JOA score. On multivariate analysis, risk factors for U/E residual pain were long illness duration and poor preoperative JOA score, whereas those for L/E residual pain were age and poor preoperative JOA score. Conclusions: The risk factors for residual spinal neuropathic pain after c-OPLL surgery were age, long duration of illness, and poor preoperative JOA score. Level of Evidence: IV

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Section: Discussionmentioning

confidence: 87%

Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament

Miyagi

Inoue

Yoshii

et al. 2023

Clinical Spine Surgery: A Spine Publication

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“…However, the posterior cervical spine also has its own defects, which can break down in the rear of the cervical muscle ligament complex, result in the destruction of the cervical vertebra rear anatomical structure and loss of stability, and cause post-operative stiffness, acid bilges, and pain in the neck, shoulder, and back, called axial symptoms (AS) [13,28,29]. Previous studies have shown that various factors may cause axial symptoms after surgery, including the choice of surgical method, the stability of posterior structures, the postoperative range of motion of the cervical spine, and the degree of soft tissue injury around the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Cohort Study of a Modified Open-Door Laminoplasty With Reconstruction of The Cervical Posterior Ligamental Complex to Decrease Axial Pain in Cervical Spondylotic Myelopathy

2023

IJOR

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Background: Cervical spondylotic myelopathy patients with multiple segments are usually treated with surgery via the posterior approach, but expansive open laminoplasty (ELAP) often results in heavy, rigid, and acid bilge feelings in the neck, shoulder, and back, collectively known as axial symptoms. To evaluate the effect of modified posterior cervical ligament complex reconstruction and single-door laminoplasty with titanium plate fixation on postoperative axial symptoms in patients. Methods: We conducted a retrospective study including 132 cases of cervical spondylotic myelopathy at our institute from June 2016 to March 2018. The patients who conformed to the inclusion criteria were randomly divided into two different surgical groups by by the surgeons. Gender, age, operation time, intraoperative blood loss, post-operative drainage volume, and follow-up time, Visual analogue scoring (VAS), cervical curvature index (CCI) and the cross-sectional area of the posterior cervical muscles of the two groups were recorded. Results: There was statistical significance in the incidence of axial pain 3 months after surgery (P = 0.001), 6 months after surgery (P = 0.006), and 1 year after surgery (P = 0.015). Compared to group b, the VAS score in group A was decreased one month (P <0.0001), 3 months (P=0.0001), 6 months(P=0.0076), and 1 year(P=0.0085) after surgery. The CCI and the posterior cervical muscle area also differed significantly between the two groups (P < 0.0001). Conclusions: Modified single open-door laminoplasty could relieve cervical axial pain in patients with cervical spondylotic myelopathy

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“…Several items of NDI deal with the subjective perception of comfort. Though bias seems inevitable with NDI, postoperative cervical functional status of the patient does have a considerable impact on the patients’ life quality [18]. We think that NDI has a certain clinical significance and serves as an important measure for surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Posterior open-door laminoplasty secured with titanium miniplates vs anchors: a comparative study of clinical efficacy and cervical sagittal balance

Li¹,

Hai²,

Meng³

et al. 2019

J Orthop Surg Res

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ObjectivePosterior open-door laminoplasty (PODL) is a common procedure for treating multilevel cervical spondylotic myelopathy (MCSM). Little information is available regarding the cervical sagittal balance and surgical efficacy of PODL when securing with different methods. Therefore, this study aims to investigate the clinical outcomes and the changes in cervical sagittal parameters and balance associated with PODL secured with titanium miniplates vs anchors.MethodA retrospective analysis was performed on the clinical data of 79 patients with MCSM who were treated in our institution from January 2015 to December 2016. Among them, 42 patients were treated by PODL secured with titanium miniplates (group A) and 37 patients by PODL secured with anchors (group B). Surgical time, intraoperative blood loss, hospital stay, hospitalized cost, VAS scores of neck pain, JOA scores, neck disability index (NDI), and improvement rate of spinal neurological function (IRNF) were recorded before surgery and at 12 months after surgery. Before surgery, at 1 month and 2 years after surgery, the following radiological parameters were recorded and compared on the lateral cervical X-ray images: the distance from the vertical axis of C2 sagittal plane to the posterior superior edge of C7 (C2-7 SVA), the inclusion angle of tangent between C2 and C7 trailing edge (C2-7 Cobb angle), and the intersection angle between the upper edge of T1 and the horizontal line (T1 Slope).ResultComparing the two groups, there were no significant differences in surgical time, intraoperative blood loss, hospital stay, VAS, JOA, and NDI scores before surgery (P > 0.05); however, the hospitalized cost of group A were much higher than those of the group B (P < 0.05). At 2 years after surgery in the two groups, there was a significant reduction in VAS and NDI scores (P < 0.05), and JOA scores increased significantly (P < 0.05). In addition, there were no significant differences in VAS, JOA and IRNF between the two groups (P > 0.05); however, NDI scores of group A were better than those of group B (P < 0.05). In radiological parameters, before surgery, the two groups showed no significant differences in C2-7 SVA, C2-7 Cobb angle, and T1 slope (P > 0.05); however, after surgery, C2-7 SVA and T1 slope increased (P < 0.05), while C2-7 Cobb angle decreased (P < 0.05). At 2 years after surgery, the two groups did not differ significantly in C2-7 Cobb angle and T1 slope (P > 0.05), while C2-7 SVA of group A was superior to that of group B (P < 0.05). The difference value of C2-7 SVA measured before and after surgery was correlated negatively with that of NDI scores (P < 0.05).ConclusionPODL secured with titanium miniplates or anchors achieved good clinical efficacy in the treatment of MCSM. However, the patients with miniplates feel a better cervical functional status, while those with anchors spend less on hospitalization. Both methods lead to anteversion of cervical spine, but cervical sagittal balance after miniplates is better than that of anchors.

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Analyses of effect factors associated with the postoperative dissatisfaction of patients undergoing open-door laminoplasty for cervical OPLL: a retrospective cohort study

Cited by 11 publications

References 30 publications

Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament

Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament

A Retrospective Cohort Study of a Modified Open-Door Laminoplasty With Reconstruction of The Cervical Posterior Ligamental Complex to Decrease Axial Pain in Cervical Spondylotic Myelopathy

Posterior open-door laminoplasty secured with titanium miniplates vs anchors: a comparative study of clinical efficacy and cervical sagittal balance

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