ANALYSIS OF RISK FACTORS OF AXIAL SYMPTOMS AFTER SINGLE DOOR LAMINOPLASTY FOR CERVICAL MYELOPATHY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XIEShuiqing ^1,2 ,  SUNTianwei ² , TIANRong ² , XUTiantong ² , JIAYutao ² , SHENQingfeng ²

1. Medical School of Nankai University, Tianjin, 300071, P. R. China;
2. Department of Spinal Surgery, the People's Hospital of Tianjin;

Corresponding author：

SUNTianwei, Email: billsuntw@163.com

Keywords：

Cervical myelopathy; Single door laminoplasty; Axial symptom; Risk factor

DOI：

10.7507/1002-1892.20140138

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the risk factors of axial symptoms after single door laminoplasty for cervical myelopathy. Methods A retrospective analysis was made on the clinical data of 102 patients with cervical myelopathy who underwent single door laminoplasty and were accorded with selective standard between February 2009 and October 2011. There were 59 males and 43 females, aged 35 to 72 years (mean, 58 years). The disease duration was 1-70 months (mean, 18 months). The operated segments included C_3-7 in 58 cases, C_3-6 in 23 cases, C_4-7 in 15 cases, and C_3-5 in 6 cases. The visual analogue scale (VAS) was used to determine whether the patient had axial symptoms (group A) or not (group B). The logistic regression analysis was used to analyze the risk factors of postoperative axial symptoms by assessing the following indexes:preoperative VAS score, preoperative Japanese Orthopaedic Association (JOA) score, gender, age, disease duration, operated segment, operation time, intraoperative blood loss, wearing collar time, preoperative encroachment rate of anterior spinal canal, preoperative cervical curvature, and preoperative cervical range of motion. Results A total of 102 cases were followed up 18-26 months (mean, 24 months). And no postoperative spinal cord injury, cerebrospinal fluid leakage, or infection occurred. Of 102 cases, 50 had axial symptoms (group A) and 52 had no axial symptoms (group B). There were significant differences in age, wearing collar time, preoperative cervical range of motion, preoperative cervical curvature, and preoperative encroachment rate of anterior spinal canal between 2 groups (P<0.05), but no significant difference was found in preoperative JOA score and VAS score, blood loss, gender, disease duration, operated segment, and operation time (P>0.05). The logistic regression analysis showed that the increased preoperative encroachment rate of anterior spinal canal, reduced preoperative cervical curvature, and preoperative cervical range of motion loss were the risk factors for cervical axial symptoms. Conclusion Age, wearing collar time, preoperative cervical range of motion, preoperative encroachment rate of anterior spinal canal, and preoperative cervical curvature are relevant factors of axial symptoms; increased preoperative encroachment rate of anterior spinal canal, reduced preoperative cervical curvature, and preoperative cervical range of motion loss are risk factors for cervical axial symptoms.

Citation： XIEShuiqing, SUNTianwei, TIANRong, XUTiantong, JIAYutao, SHENQingfeng. ANALYSIS OF RISK FACTORS OF AXIAL SYMPTOMS AFTER SINGLE DOOR LAMINOPLASTY FOR CERVICAL MYELOPATHY. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(5): 620-624. doi: 10.7507/1002-1892.20140138 Copy

1.	Hosono N, Yonenobu K, Ono K. Neck and shoulder pain after laminoplasty a noticeable complication. Spine J, 1996, 21(17):1969-1973.
2.	孙天威, 张杭, 卢守亮, 等. 颈椎单开门椎管扩大成形术椎板开门角度对脊髓型颈椎病疗效的影响. 中国修复重建外科杂志, 2012, 22(1):8-13.
3.	Ara T, Iizuka H, Sorimachi Y, et al. Evaluation of neck pain by using a visual analog scale before and after laminoplasty in patients with cervical myelopathy:relationship with clinical results. Neurosurg Spine J, 2010, 12(6):635-640.
4.	Kawaguchi Y, Matsui H, Ishihara H, et al. Axial symptoms after en bloc cervical laminoplasty. J Spinal Disord, 1999, 12(5):392-395.
5.	孙宇. 关于轴性症状. 中国脊柱脊髓杂志, 2008, 18(4):289.
6.	Ono A, Tonosaki Y, Numasawa T, et al. The relationship between the anatomy of the nuchal ligament and postoperative axial pain after cervicallaminoplasty:cadaver and clinical study. Spine (Phila Pa 1976), 2012, 37(26):E1607-1613.
7.	Wang SJ, Jiang SD, Jiang LS, et al. Axial pain after posterior cervical spine surgery:a systematic review. Eur Spine J, 2011, 20(2):185-194.
8.	Yoshida M, Tamaki T, Kawakami M, et al. Does reconstruction of posterior ligamentous complex with extensor musculature decrease axial symptoms after cervical laminoplasty? Spine (Phila Pa 1976), 2002, 27(13):1414-1418.
9.	Ito M, Nagahama K. Laminoplasty for cervical myelopathy. Global Spine J, 2012, 2(3):187-194.
10.	Meada T, Arizono T, Saito T, et al. Cervical alignment, range of motion, and instability after cervical laminoplasty. Clin Orthop Relat Res, 2002, (401):132-138.
11.	Kawaguchi Y, Kanamori M, Ishiara H, et al. Preventive measures for axial symptoms following cervical laminoplasty. J Spinal Disord Tech, 2003, 16(6):497-501.
12.	Hyun SJ, Riew KD, Rhim SC. Range of motion loss after cervical laminoplasty:a prospective study with minimum 5-year follow-up data. Spine J, 2013, 13(4):384-390.
13.	Du W, Wang L, Shen Y, et al. Long-term impacts of different posterior operations on curvature, neurological recovery and axial symptoms for multilevel cervical degenerative myelopathy. Eur Spine J, 2013, 22(7):1594-1602.
14.	Yusof MI, Hassan E, Abdullah S. Predicted cervical canal enlargement and effective cord decompression following expansive laminoplasty using cervical magnetic resonance imaging. Surg Radiol Anat, 2011, 33(2):109-115.
15.	Kato M, Nakamura H, Konishi S, et al. Effect of preserving paraspinal muscles on postoperative axial pain in the selective cervical laminoplasty. Spine (Phila Pa 1976), 2008, 33(14):E455-459.
16.	潘胜发, 孙宇, 朱振军, 等. 单开门颈椎管扩大椎板成形术后轴性症状与颈椎稳定性的相关观察. 中国脊柱脊髓杂志, 2012, 13(10):604-607.
17.	Sakaura H, Hosono N, Mukai Y, et al. Medium-term outcomes of C_3-6 laminoplasty for cervical myelopathy:a prospective study with a minimum 5-year follow-up. Eur Spine J, 2011, 20(6):928-933.
18.	Okada M, Minamide A, Endo T, et al. A prospective andomized study of clinical outcomes in patients with cervical compressive myelopathy treated with open-door or French-door laminoplasty. Spine (Phila Pa 1976), 2009, 34(11):1119-1126.

1. Hosono N, Yonenobu K, Ono K. Neck and shoulder pain after laminoplasty a noticeable complication. Spine J, 1996, 21(17):1969-1973.
2. 孙天威, 张杭, 卢守亮, 等. 颈椎单开门椎管扩大成形术椎板开门角度对脊髓型颈椎病疗效的影响. 中国修复重建外科杂志, 2012, 22(1):8-13.
3. Ara T, Iizuka H, Sorimachi Y, et al. Evaluation of neck pain by using a visual analog scale before and after laminoplasty in patients with cervical myelopathy:relationship with clinical results. Neurosurg Spine J, 2010, 12(6):635-640.
4. Kawaguchi Y, Matsui H, Ishihara H, et al. Axial symptoms after en bloc cervical laminoplasty. J Spinal Disord, 1999, 12(5):392-395.
5. 孙宇. 关于轴性症状. 中国脊柱脊髓杂志, 2008, 18(4):289.
6. Ono A, Tonosaki Y, Numasawa T, et al. The relationship between the anatomy of the nuchal ligament and postoperative axial pain after cervicallaminoplasty:cadaver and clinical study. Spine (Phila Pa 1976), 2012, 37(26):E1607-1613.
7. Wang SJ, Jiang SD, Jiang LS, et al. Axial pain after posterior cervical spine surgery:a systematic review. Eur Spine J, 2011, 20(2):185-194.
8. Yoshida M, Tamaki T, Kawakami M, et al. Does reconstruction of posterior ligamentous complex with extensor musculature decrease axial symptoms after cervical laminoplasty? Spine (Phila Pa 1976), 2002, 27(13):1414-1418.
9. Ito M, Nagahama K. Laminoplasty for cervical myelopathy. Global Spine J, 2012, 2(3):187-194.
10. Meada T, Arizono T, Saito T, et al. Cervical alignment, range of motion, and instability after cervical laminoplasty. Clin Orthop Relat Res, 2002, (401):132-138.
11. Kawaguchi Y, Kanamori M, Ishiara H, et al. Preventive measures for axial symptoms following cervical laminoplasty. J Spinal Disord Tech, 2003, 16(6):497-501.
12. Hyun SJ, Riew KD, Rhim SC. Range of motion loss after cervical laminoplasty:a prospective study with minimum 5-year follow-up data. Spine J, 2013, 13(4):384-390.
13. Du W, Wang L, Shen Y, et al. Long-term impacts of different posterior operations on curvature, neurological recovery and axial symptoms for multilevel cervical degenerative myelopathy. Eur Spine J, 2013, 22(7):1594-1602.
14. Yusof MI, Hassan E, Abdullah S. Predicted cervical canal enlargement and effective cord decompression following expansive laminoplasty using cervical magnetic resonance imaging. Surg Radiol Anat, 2011, 33(2):109-115.
15. Kato M, Nakamura H, Konishi S, et al. Effect of preserving paraspinal muscles on postoperative axial pain in the selective cervical laminoplasty. Spine (Phila Pa 1976), 2008, 33(14):E455-459.
16. 潘胜发, 孙宇, 朱振军, 等. 单开门颈椎管扩大椎板成形术后轴性症状与颈椎稳定性的相关观察. 中国脊柱脊髓杂志, 2012, 13(10):604-607.
17. Sakaura H, Hosono N, Mukai Y, et al. Medium-term outcomes of C_3-6 laminoplasty for cervical myelopathy:a prospective study with a minimum 5-year follow-up. Eur Spine J, 2011, 20(6):928-933.
18. Okada M, Minamide A, Endo T, et al. A prospective andomized study of clinical outcomes in patients with cervical compressive myelopathy treated with open-door or French-door laminoplasty. Spine (Phila Pa 1976), 2009, 34(11):1119-1126.

Chinese Journal of Reparative and Reconstructive Surgery

ANALYSIS OF RISK FACTORS OF AXIAL SYMPTOMS AFTER SINGLE DOOR LAMINOPLASTY FOR CERVICAL MYELOPATHY

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content