Axial Symptoms After En Bloc Cervical Laminoplasty

Kawaguchi, Yoshiharu; Matsui, Hisao; Ishihara, Hirokazu; Gejo, Ryuichi; Yoshino, Osamu

doi:10.1097/00002517-199910000-00007

Cited by 51 publications

(39 citation statements)

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“…[29][30][31][32] This technique preserves motion but has been reported to have a higher incidence of root injury 33 and axial neck pain. 34,35 Coupled with this, the technique is preferably performed in patients with lordotic spinal alignment, with neutral or kyphotic patients potentially worsening their deformity after surgery. When looking at this surgical series, all patients had improvements in the ONDI and reported neck movements that did not interfere with activities of daily living.…”

Section: Discussionmentioning

confidence: 99%

Posterior cervical decompression and fusion for circumferential spondylotic cervical stenosis: Review of 50 consecutive cases

Sekhon¹

2006

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

Posterior cervical decompression and fusion for circumferential spondylotic cervical stenosis: Review of 50 consecutive cases

Sekhon¹

2006

Journal of Clinical Neuroscience

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“…[1][2][3][4][5][6][7] Since the first report of intractable neck and shoulder pain as a noticeable complication after cervical laminoplasty by Hosono et al, 8 postlaminoplasty axial pain has come to be recognized as one of the most notorious complications. [9][10][11][12][13] However, to our knowledge, little information is available concerning local pain associated with posterior thoracic spine surgery. We therefore prospectively investigated the frequency and clinical features of local pain in patients undergoing posterior spine surgery for thoracic lesions and discuss herein the possible pathogenesis of persistent local pain after surgery.…”

mentioning

confidence: 99%

Persistent Local Pain After Posterior Spine Surgery for Thoracic Lesions

Sakaura¹,

Hosono²,

Mukai³

et al. 2007

Journal of Spinal Disorders &Amp; Techniques

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Many surgeons have investigated local pain associated with posterior spine surgery for cervical or lumbar lesions. However, little information is available concerning local pain after posterior thoracic spine surgery. This prospective study was, thus, performed to investigate the frequency and clinical features of local pain after posterior spine surgery for thoracic lesions. In 29 consecutive patients undergoing posterior spine surgery for various thoracic spinal disorders, local pain was investigated before and after surgery. In all 19 patients with preoperative back pain presumably due to thoracic lesions, pain was well alleviated after surgery. In contrast, 6 patients (21%) newly developed persistent shoulder angle pain after surgery, which resembled axial pain after cervical laminoplasty. In 5 of these 6 patients surgical exposure was extended to the cervicothoracic junction, whereas persistent shoulder angle pain was independent of disease etiologies and surgical procedure, and all of the 5 patients had no other etiologies of local pain such as surgical site infections, hardware failures, pseudoarthrosis, other metastasis, and vertebral fractures. These results suggest that dissection of muscle attachments to the cervicothoracic junction would play some part in the development of persistent local pain after posterior spine surgery for thoracic lesions, although surgical exposure of the zygapophysial joints at the cervicothoracic junction might be a possible source of postoperative shoulder pain. Therefore, to minimize such surgical complications, muscle insertions into the cervicothoracic junction should be preserved as far as possible.

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“…The muscles of the head and neck region are characteristically rich in proprioceptors that send afferents directly to the vestibulo-spinal and the vestibulo-oculomotor neurones [17]. So, subperiosteal dissection of the paraspinal muscles can result in muscular pain and spasms, which are common with the conventional posterior approach [3,5,12,13,19,21]. Consequently, a technique that minimises trauma to the posterior paraspinal muscles of the neck offers many advantages and a better functional outcome.…”

Section: Discussionmentioning

confidence: 99%

“…have the disadvantage of detaching the extensor cervical muscles from the laminae and the spinous processes [7,11]. This operative trauma to the cervical paraspinal muscles is a major cause of postoperative complications that may be in the form of persistent neck and shoulder pain, and sometimes spinal instability may be the end result [3,12,13,23]. Roh et al [19] described the use of microendoscopic posterior cervical foraminotomy in a cadaveric study (four cadavers), and Burke and Caputy [5] reported on the use of the same technique in a combined cadaveric and clinical study (three cadavers and three patients).…”

mentioning

confidence: 99%