Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis

Abstract

Although difficulties with neck mobility often interfere with patients' activities of daily living (ADL) after cervical laminoplasty, there was no detailed study on the relation between the limitations of ADL accompanying postoperative reduced neck mobility and the cervical posterior approach. The aim of this study was to compare retrospectively the frequency of limitations of ADL accompanying neck mobility after laminoplasty preserving the semispinalis cervicis inserted into the C2 spinous process with that after laminoplasty reattaching the muscle to C2. Forty-nine patients after C4-C7 laminoplasty with C3 laminectomy preserving the semispinalis cervicis inserted into C2 (Group A) and 24 patients after C3-C7 laminoplasty reattaching the muscle (Group B) were evaluated. The frequency of postoperative limitations of ADL accompanying each of three neck movements of extension, flexion and rotation were investigated. The postoperative O-C7 angles at extension and flexion was measured on lateral extension and flexion radiographs of the cervical spine, respectively. The postoperative cervical range of motion in rotation was measured in the cranial view using a digital camera. Frequency of limitations of ADL accompanying extension was lower (P = 0.037) in Group A (2%) than in Group B (17%). Frequency of limitations of ADL accompanying flexion was similar in Group A (8%) and Group B (4%). Frequency of limitations of ADL accompanying rotation was lower (P = 0.031) in Group A (12%) than in Group B (33%). Average O-C7 angle at extension was significantly larger (P = 0.002) in Group A (147°) than in Group B (136°). Average O-C7 angle at flexion was similar in Group A (93°) and Group B (91°). Average range of motion in rotation was significantly larger (P = 0.004) in Group A (110°) than in Group B (91°). This retrospective study suggested that the frequency of limitations of ADL accompanying neck extension or rotation was lower after laminoplasty preserving the semispinalis cervicis inserted into C2 than after laminoplasty reattaching the muscle.

Long-term results of double-door laminoplasty using hydroxyapatite spacers in patients with compressive cervical myelopathy

“…In addition, modified surgical techniques have been developed to preserve the paraspinal muscles, not only to maintain cervical ROM, but also to reduce axial symptoms [11,12]. Roselli et al [12] reported well-preserved cervical ROM after open-door laminoplasty using unilateral muscle dissection, while Takeuchi et al [11,13] maintained cervical ROM following double-door laminoplasty by preserving the semispinalis cervicis inserted into C2. Because bilateral muscle dissection is inevitable during double-door laminoplasty, further modifications to the surgical techniques are desirable to preserve the integrity of the cervical muscles.…”

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament

“…Decreased excursive ROM, 2,9,25,39,40,52 cervical malalignment, 3,5,16,18,37 late exacerbation of myelopathy symptoms, 19,25,40 and axial neck pain are postoperative problems associated with laminoplasty. 2,5,22,23,25,37,39,43,46 Axial neck pain greatly reduces patient satisfaction with the procedure. 13,24,45 Moreover, decreased lordotic curvature and kyphosis, which involve the semispinalis cervi-A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament Object.…”

Immediate Effect of Neck Stabilization Exercise on Neck Repositioning Accuracy in Chronic Neck Pain Patients

“…The source of neck may be due to many varying pathologies such as whiplash, poor posture, degenerative disorders, neuropathy, tumors, surgical procedures and over working of neck muscles due to faulty postures [2][3][4][5][6].…”