A Prospective Randomized Study of Clinical Outcomes in Patients With Cervical Compressive Myelopathy Treated With Open-Door or French-Door Laminoplasty

Abstract

Perioperative complications occurred more frequently in open-door laminoplasty than in French-door laminoplasty. JOA scores and recovery rates suggested that both open-door and French-door laminoplasties could be similarly effective in decompressing the spinal cord. Axial pain was improved in French-door laminoplasty but became worse in open-door laminoplasty. SF-36 suggested that French-door laminoplasty could be more beneficial than open-door laminoplasty for patients with cervical compressive myelopathy.

Axial pain after posterior cervical spine surgery: a systematic review

“…The relation between cervical mobility and axial pain has been noted [17,31], as the decrease in cervical lordosis or increase in cervical kyphosis would produce more axial pain. However, other studies [6,11,15,16,19,20] showed that postoperative axial pain did not correlate with postoperative cervical mobility.…”

“…The measurement parameters were defined as cervical alignment (C2-7 Cobb angle), flexion-extension neck range of motion (ROM), anteroposterior diameter of the spinal canal (A-P canal diameter), preoperative instability, lamina closure and number of fused levels (Table 1). There were eight studies with the data on postoperative cervical alignment [6,31,47], changes in alignment [16], postoperative ROM [6,11,15,19,20] and changes in ROM [11,16]. The results showed that these factors were not correlated with postoperative axial pain in all these studies except one [31], in which minimal correlation between positive change of Cobb angle and improvement in axial pain was found.…”

“…There were eight studies with the data on postoperative cervical alignment [6,31,47], changes in alignment [16], postoperative ROM [6,11,15,19,20] and changes in ROM [11,16]. The results showed that these factors were not correlated with postoperative axial pain in all these studies except one [31], in which minimal correlation between positive change of Cobb angle and improvement in axial pain was found. There were no significant differences between postoperative axial pain and A-P canal diameter [47], preoperative instability [20] or lamina closure [26], but the number of fused laminae [19] was significantly related to postoperative axial pain.…”

“…The incidence of postoperative axial pain was reported to increase in three studies [16,30,47] and to decline in three [2,20,21], respectively, as compared to preoperatively. One study [31] showed postoperative aggravation of axial pain, whereas five [1,2,11,25,42] reported pain alleviation. Three studies [7,9,36] focused on early axial pain and late axial pain after surgery found that the frequencies of early axial pain were higher than late axial pain.…”

“…Thirteen studies compared surgical approaches to determine which approach would significantly reduce the incidence or severity of axial pain ( Table 2). The results of 8 of these 13 studies [7,17,22,31,[40][41][42]44] suggested that modified laminoplasty produced less axial pain than conventional laminoplasty. Modified laminoplasty included less invasive surgery and reconstructive technique.…”