Investigation of axial symptoms after cervical laminoplasty, using questionnaire survey

Ohnari, Hiroyuki; Sasai, Keisuke; Akagi, Shigeo; Iida, Hiroya; Saito, Takanori; Kato, Isashi

doi:10.1016/j.spinee.2005.10.014

Cited by 44 publications

(48 citation statements)

References 17 publications

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“…There is the potential for a higher rate of infection, surgical morbidity and increased inhospital stay. Posterior dissection can cause significant myofascial pain due to the stripping of the musculature from the posterior elements and axial neck pain [5,18,52,85,89,103,110,119]. Two of our three cases sustaining posterior fusion depicted severe and moderate posterior neck pain, respectively.…”

Section: Clinical Failures In Multilevel Anterior Cervical Constructsmentioning

confidence: 77%

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

et al. 2007

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In the future, there will be an increased number of cervical revision surgeries, including 4-and more-levels. But, there is a paucity of literature concerning the geometrical and clinical outcome in these challenging reconstructions. To contribute to current knowledge, we want to share our experience with 4-and 5-level anterior cervical fusions in 26 cases in sight of a critical review of literature. At index procedure, almost 50% of our patients had previous cervical surgeries performed. Besides failed prior surgeries, indications included degenerative multilevel instability and spondylotic myelopathy with cervical kyphosis. An average of 4.1 levels was instrumented and fused using constrained (26.9%) and non-constrained (73.1%) screw-plate systems. At all, four patients had 3-level corpectomies, and three had additional posterior stabilization and fusion. Mean age of patients at index procedure was 54 years with a mean follow-up intervall of 30.9 months. Preoperative lordosis C2-7 was 6.5°in average, which measured a mean of 15.6°at last follow-up. Postoperative lordosis at fusion block was 14.4°in average, and 13.6°at last follow-up. In 34.6% of patients some kind of postoperative change in construct geometry was observed, but without any catastrophic construct failure. There were two delayed unions, but finally union rate was 100% without any need for the Halo device. Eleven patients (42.3%) showed an excellent outcome, twelve good (46.2%), one fair (3.8%), and two poor (7.7%). The study demonstrated that anterior-only instrumentations following segmental decompressions or use of the hybrid technique with discontinuous corpectomies can avoid the need for posterior supplemental surgery in 4-and 5-level surgeries. However, also the review of literature shows that decreased construct rigidity following more than 2-level corpectomies can demand 360°instrumentation and fusion. Concerning construct rigidity and radiolographic course, constrained plates did better than non-constrained ones. The discussion of our results are accompanied by a detailed review of literature, shedding light on the biomechanical challenges in multilevel cervical procedures and suggests conclusions.

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Section: Clinical Failures In Multilevel Anterior Cervical Constructsmentioning

confidence: 77%

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

et al. 2007

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“…Of 26 studies, 5 utilized age as the influencing factor. Three studies [19,30,47] found no significant difference in age between mild and severe axial pain group, or between axial pain and no axial pain group. One study [16] found that older age ([63 years) significantly decreased the risk of postoperative axial pain (Table 1).…”

Section: Agementioning

confidence: 98%

“…Only one study [29] reported that the incidence of axial pain in women was twice as much as in men. 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.…”

Section: Clinical Featuresmentioning

confidence: 98%

“…Some authors [19,30,42] also utilized the questionnaires to analyze the severity of axial pain. Time-related change of the degree of axial pain was characterized by gradual decrease in VAS after surgery [42,47].…”

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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Predicted cervical canal enlargement and effective cord decompression following expansive laminoplasty using cervical magnetic resonance imaging

2010

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Investigation of axial symptoms after cervical laminoplasty, using questionnaire survey

Cited by 44 publications

References 17 publications

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

Axial pain after posterior cervical spine surgery: a systematic review

Predicted cervical canal enlargement and effective cord decompression following expansive laminoplasty using cervical magnetic resonance imaging

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