Neck Pain following Laminoplasty

Abstract

Study Design Retrospective evaluation of prospectively collected data. Objective To compare preoperative and postoperative neck pain following laminoplasty using the Neck Disability Index (NDI). Methods Seventy-two patients undergoing laminoplasty from 2006 to 2009 at a single institution were identified. Thirty-four patients with a minimum 1-year follow-up who completed preoperative, 6-week, and 1-year postoperative NDI questionnaires were enrolled. Demographic data and surgical data including estimated blood loss (EBL), length of surgery, number of laminoplasty levels, complications, and length of hospitalization were collected. Results Mean age was 62 years (range: 34 to 88), mean follow-up was 17 months (range: 12 to 31), and there were 21 men and 13 women. Diagnoses were cervical spondylotic myelopathy (n = 26), ossification of the posterior longitudinal ligament (n = 6), and central cord syndrome (n = 2). Mean EBL was 120 mL (range: 50 to 200), and mean surgical time was 152 minutes (range: 70 to 240). Average number of laminoplasty levels was 3 (range: 1 to 5). The open door technique was used, and 24/34 (71%) did not have laminoplasty at C3 and C7. No intraoperative complications were noted, and average hospital stay was 1.6 days (range: 1 to 7). Significant improvement in NDI total score was noted at 1 year (p < 0.002) and in NDI pain score at 6 weeks (p < 0.028) and 1 year (p < 0.007) postoperatively. Conclusions Patients having laminoplasty experienced significant improvement in NDI pain subscore and NDI total scores at a minimum of 1 year postoperatively.

Microscope-assisted anterior cervical discectomy and fusion combined with posterior minimally invasive surgery through tubular retractors for multisegmental cervical spondylotic myelopathy

“…[ 21 ] We retained the cervical muscle ligament complex, thus reducing the incidence of axial symptoms. [ 22 , 23 ] However, supreme mastery is needed to apply this technique to multisegmental ossification of the posterior longitudinal ligament, given the serious adhesions to the ventral surface. Also, the surgery time is longer, requiring increased patient tolerance.…”

Expansive Open-Door Cervical Laminoplasty

“… 11 , 12 However, after operations a variety of symptoms remain or occur, including neck and shoulder pain, stiffness, and limited neck motion. 13 We believe that expansive open-door cervical laminoplasty creates a relative large injury and will cause damage of the ligament complex to various degrees when relaxing pressure. Because attachment relationships between posterior cervical muscular attachment points and spinous process cannot be reconstructed, posterior cervical extensors become atrophic and weak; in addition, postoperative long-time neck immobilization will cause neck symptoms.…”

Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

“…Similarly, several studies used the NDI score as a parameter of clinical outcome and reported that laminoplasty improved the NDI score within 1-2 years of post operation [39,43]. Interestingly, Shin et al [35] used the Frankel score to measure the clinical outcome of laminoplasty and found an improvement in the Frankel score from 3.93 to 4.53 at 12 months post operation.…”

“…We believe that the dissection of muscular attachment at C2 and C7 is the cause of this complication; the preservation of them can reduce postoperative axial neck pain. Mesfin et al [43] demonstrated that by performing C4-C6 laminoplasty, the NDI pain subscore decreased from 1.3 to 0.7 at 1 year follow-up. The pain subscore was already low before the operation and became even lower at 1 year post operation.…”

“…They preserved the C2 and C7 muscle attachments in their operation technique. Mesfin et al [43] suggested that if the compression HATASO rabm.scholasticahq.com is at the C3 level, it is better to perform laminectomy in the C3 level than laminoplasty to preserve the C2 semispinalis cervicis. Nevertheless, both of these studies lack a control group; considerable controlled studies are essential.…”