Risk factors of axial pain after unilateral open-door cervical laminoplasty with mini-plate fixation

English Keywords:Cervical laminoplsty  Axial symptoms  Mini-plate  Multivariate analysis  Cervical ROM  Facet joints

English Abstract:

  【Abstract】 Objectives: To detect the risk factors of axial pain by multivariate analysis in cervical laminoplasty with mini-plate fixation. Methods: A total of 219 patients who underwent cervical laminoplasty with mini-plate fixation was reviewed from December 2008 to March 2016. Patients were divided into two groups: patients with and patients without postoperative axial pain. The clinical data were recorded, including gender, age, duration of symptoms, diagnosis type, medical co-morbidity, operation level, blood loss, operation time, pre- and post- JOA score, JOA recovery rate, and other complications. The radiograhic data including cervical canal diameter, C2-7 Cobb angle, cervical range of motion(ROM), cross-sectional area, open angle, hinge union, and facet joint destroyed were measured in X-ray and CT scan images. The univariate analysis and multivariate logistic regression analysis were performed. Results: There were 63 patients suffered from axial pain. Both groups gained significant JOA improvement after surgery(P<0.05). The preoperative neck pain, postoperative cervical alignment type, change of cervical curvature, cervical instability, negative change of cervical ROM and facet joints destroyed were included in multivariate analysis. There was no significant difference of other clinical and radiographic parameters between the groups(P>0.05). The multivariate analysis showed that the negative change of cervical ROM(P=0.047) and facet joints destroyed(P=0.041) were related to axial pain. Conclusions: The decrease of cervical ROM and facet joints destroyed by mini-screws may be risk factors of axial pain after cervical laminoplasty with mini-plate fixation. Cervical spine surgeons should carefully operate to decrease the injury of posterior musculature structure and protect the facet joints.