Prognosis of postoperative axial pain after unilateral laminoplasty for cervical stenotic myelopathy
GONG Teng1, 2, SU Xuetao1, XIA Qun1, WANG Jinggui1
1. The Affiliated Hospital of Logistics College of Chinese People's Armed Police Force, Tianjin 300162,China; 2. Tianjin Hospital,Tianjin 300211, China; 3. Tianjin Medical University, Tianjin 300070,China
Abstract：Objective To investigate the risk factors for predicting the duration of postoperative axial pain(PAP) for multi-level cervical stenosis myelopathy(CSM) treated by unilateral laminoplasty fixed with centerpiece mini-plates. Methods Clinical data about a total of 344 patients with CSM who had undergone the above-mentioned laminoplasty was retrospectively analyzed after a minimum of three years of follow-up. The participants were classified into the fast recovery group (2 to 5 months) and slow recovery group (6 to 16 months) according to the duration of PAP. The differences in the bony fusion rate on the hinge side and JOA improvement rate at postoperative 6 months, the correction value of the Visual Analogue Score and Neck Disability Index during the final follow-up compared with the initial onset, and the correction value of the range of motion, static alignment, mid-sagittal diameter of cervical canal immediately after operation in contrast to preoperative conditions were compared between the two groups. Multivariate logistic regression analysis was used to verify the association between the preoperative Cobb angle, canal sagittal diameter at the maximally compressed level, range of motion,fusion rate and PAP development. Results All the 32 cases with PAP got relieved after the conservative treatment, 21 of whom were relieved within 2.8 to 4.8 months, and the rest within 6.9 to 15.5 months. The fusion rate on the hinge side at postoperative 6 months in the fast recovery group was higher than that in the slow recovery group, and the difference was of statistical significance(Z=2.18,P=0.04). Fusion rate was the only independent factor for predicting the duration of PAP(OR=4.9619,P=0.0465). Conclusions Fast and reliable fusion of bones on the hinge side after unilateral laminoplasty can help shorten the duration of PAP.
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2017, Vol. 28 
