Etiology of postoperative axial pain after cervical unilateral laminoplasty combined with pedicle fixation
GONG Teng1,2,3, SU Xuetao1, XIA Qun1, WANG Jinggui1
1.The second Department of Spine Surgery of Central Theatre of Orthopaedics,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 etiology and influence of postoperative axial pain among patients with multilevel ossification of cervical posterior longitudinal ligament(OPLL) after unilaterally expansive laminoplasty fixed with pedicle screws and rods.Methods This study retrospectively reviewed 106 OPLL patients who had undergone unilaterally expansive laminoplasty supplemented by successive bilateral pedicle fixation with a minimum of 36 months of follow-up.The proportion of preoperative single-level unsteadiness, postoperative corrected values of canal mid-sagittal diameter,open-laminar angle,Pavlov ratio,cross-sectional area of dural sac,physical curvature,drift-back distance,and Japanese Orthopaedic Assoaiation Scale JOA recovery amplitude at postoperative 3 months were compared between the PAP group and the non-PAP group.Results In term of Visual Analogue Scale(VAS) of initial onset,PAP patients were composed of ten cases of grade 2,five cases of grade 2.5, three cases of grade 3, and one case of grade 3.5.Their symptoms were relieved via conservative treatment within 3.7 to 10.9 months.The rate of short-segment instability before surgery in the PAP group was higher than that in the non-PAP group,and the difference was of statistic significance. The OA score in PAP group improved as much as in the non-PAP group,but there was statistically significant difference.The other observed parameters were not significantly different.Conclusions Multilevel OPLL patients are more vulnerable to PAP if preoperative cervical short-level instability occurs.The occurrence of PAP will not negatively affect early efficacy and rehabilitation of neurologic function after operation.
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2018, Vol. 29 
