Neck and Shoulder Pain After Laminoplasty

Hosono, Noboru; Yonenobu, Kazuo; Ono, Katsuhiko

doi:10.1097/00007632-199609010-00005

Cited by 391 publications

(186 citation statements)

References 9 publications

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“…Downward displacement of the upper extremities may induce axial pain in the sitting position [7]. Most of the patients experienced neck and shoulder pain in the early postoperative stages, and then these symptoms subsided gradually [10,22,42,48]. However, intractable axial pain might persist for more than 10 years after surgery [35], and often influences patients' quality of life [1,2,15,16,36,47].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Time-related change of the degree of axial pain was characterized by gradual decrease in VAS after surgery [42,47]. The patients often did not need analgesics to relieve postoperative axial pain [1,2,47], but researchers of two studies [10,25] observed that a few patients (8-13%) needed mild analgesics due to axial pain.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Since first described in 1996 [10], axial pain has been defined as pain from the nuchal to the periscapular or shoulder region [1,2,16,22,30,38]. Such a complication has been reported mainly after posterior cervical surgery, but has been documented also in the anterior procedure.…”

Section: Introductionmentioning

confidence: 99%

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Axial pain after posterior cervical spine surgery: a systematic review

et al. 2010

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Posterior operative approach has been the standard treatment for cervical compressive myelopathy, and axial pain after laminoplasty or laminectomy as a postoperative complication is now gradually receiving more and more attention. The objective of this study was to provide a systematic review of the current understanding of axial pain after cervical laminoplasty and laminectomy, and summarize clinical features, influence factors and preventive measures of axial pain after posterior decompressive surgery based on a review of literature published in the English language. Axial pain distributes over nuchal, periscapular and shoulder regions. Posterior surgery is not the major cause of axial pain, but axial pain can be worsened by the procedure. There are many clinical factors that influence postoperative axial pain such as age, preoperative axial pain, different surgical technique and postoperative management, but most of them are still controversial. Several surgical modifications have been innovated to reduce axial pain. Less invasive surgery, reconstruction of the extensor musculature, avoiding detachment of the semispinalis cervicis muscle and early removal of external immobilization have proved to be effective. Axial pain is under the influence of multiple factors, so comprehensive methods are required to reduce and avoid the postoperative axial pain. Because of methodological shortcomings in publications included in this systematic review, different results from different studies may be produced due to differences in study design, evaluation criteria, sample size, and incidence or severity of axial pain. More high-quality studies are necessary for drawing more reliable and convincing conclusions.

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

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Axial pain after posterior cervical spine surgery: a systematic review

et al. 2010

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“…This technique is well established and the reported complication rates are acceptable, but some problems such as axial symptoms or C5 palsy have not been fully resolved [4][5][6]. The long term results of this technique is satisfactory, with the preservation of the enlarged cervical canal area and the maintenance of JOA scores for cervical myelopathy (JOA score, Table 1, maximum score 17 points) [7].…”

Section: Introductionmentioning

confidence: 99%

Clinical results of and patient satisfaction with cervical laminoplasty for considerable cord compression with only slight myelopathy

et al. 2011

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Purpose There is no established consensus on the indications for surgery in patients with considerable cord compression but only slight myelopathy. The purpose of this study is to stimulate discussion about the indications for surgery in these patients. Methods The records of consecutive patients who underwent cervical laminoplasty (CLP) during 3.5 years were reviewed. Those patients whose pre-operative Japanese Orthopaedic Association score (JOA score, maximum 17) for cervical myelopathy was 16 points or more, indicating that they had very slight myelopathy, were selected. The postoperative JOA scores of these patients were checked via a chart review, and they were sent a survey asking about their degree of satisfaction with the results of surgery.

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“…with corpectomy [29]. Twenty-five percent of patients with laminoplasty suffer from severe neck and shoulder pain for more than 3 months [18], with significant morbidity from the iliac crest donor site etc.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

Kadaňka

Bednařík

Voháňka

et al. 2000

European Spine Journal

122

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IntroductionSpondylotic cervical myelopathy (SCM) is the most frequent cause of myelopathy in those over the age of 50 [48]. It is believed to have a generally progressive course over a period of years, with sudden acceleration especially following a slight head and neck injury, leading to significant disability [24,45,49]. The treatment of SCM remains a problem, particularly in the mild and moderate forms without rapid progression. There is no strong evidence to show that decompressive surgery with an anterior or posterior approach can improve the clinical outcome of the victims of this disease. This uncertainty persists despite the fact that decompression is a logical answer to the stenotic process, and that this approach is supAbstract A prospective randomised 2-year study was performed to compare the conservative and operative treatment of mild and moderate forms of spondylotic cervical myelopathy (SCM). Forty-eight patients presenting with the clinical syndrome of SCM, with a modified Japanese Orthopaedic Association (mJOA) score of 12 points or more, were randomised into two groups. Group A, treated conservatively, consisted of 27 patients, mean age 55.6 ± 8.6 years, while group B was treated surgically (21 patients, mean age 52.7 ± 8.1 years). The clinical outcome was measured by the mJOA score, recovery rate (RR), timed 10 m walk, score of daily activities (recorded by video and evaluated by two observers blinded to the therapy), and by the subjective assessment of the patients at 6, 12, and 24 months of the follow-up. There was, on average, no significant deterioration in mJOA score, recovery ratio, or timed 10 m walk within either group during the 2 years of follow-up. In the surgery group there was a slight decline in the scores for daily activities and subjective evaluation. A comparison of the two groups showed no significant differences in changes over time in mJOA score or quantified gait, but there were significant differences in the score of daily activities recorded by video at 24 months, which was a little lower in the surgical group, and also in RR and subjective evaluation, which were both worse in the surgical group at months 12 and 24. However, at month 6, this last parameter was significantly better in the surgical than in conservative group. Surgical treatment of mild and moderate forms of SCM in the present study design, comprising the patients with no or very slow, insidious progression and a relatively long duration of symptoms, did not show better results than conservative treatment over the 2-year follow-up.

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Neck and Shoulder Pain After Laminoplasty

Abstract: The prevalence and severity of axial symptoms after laminoplasty proved to be higher and more serious than has been believed. Such symptoms should be considered in the evaluation of the outcome of cervical spinal surgery.

Cited by 391 publications

References 9 publications

Axial pain after posterior cervical spine surgery: a systematic review

Axial pain after posterior cervical spine surgery: a systematic review

Clinical results of and patient satisfaction with cervical laminoplasty for considerable cord compression with only slight myelopathy

Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

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