Are Postoperative Neck Pain and Kyphotic Change After Laminoplasty Affected by Degree of Facet Joint Degeneration?

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-05-01 Epub Date: 2025-03-31 DOI:10.1097/BSD.0000000000001760

Gumin Jeong, Sehan Park, San Kim, Chang Ju Hwang, Jae Hwan Cho, Dong-Ho Lee

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引用次数: 0

Abstract

Study design: A retrospective cohort study.

Objective: To date, the association between postlaminoplasty neck pain or kyphosis and facet joint degeneration (FJD) remains unknown. Therefore, this study aimed to determine whether FJD affects postlaminoplasty neck pain or kyphosis.

Summary of background data: FJD can cause medial branch irritation leading to postlaminoplasty neck pain. Cervical lordosis is a prerequisite for laminoplasty as it achieves cord decompression through posterior shifting.

Methods: This study included 126 consecutive patients who underwent laminoplasty and were followed up for a minimum of 2 years. The radiographic cervical sagittal parameters, neck pain visual analog scale (VAS), arm pain VAS, neck disability index (NDI), and Japanese Orthopedic Association score were evaluated. A comparison was made between patients with moderate-to-severe neck pain (neck pain VAS ≥4; severe neck pain group) and those with mild or no neck pain (neck pain VAS <4; mild neck pain group) at the 2-year follow-up. Furthermore, patients who experienced postlaminoplasty kyphosis of C2-C7 (kyphotic group) were compared with those who did not develop kyphosis (nonkyphotic group).

Results: The mild and severe neck pain groups included 99 (78.6%) and 27 (21.4%) patients, respectively. The preoperative degree of FJD was significantly higher in the severe neck pain group ( P =0.040). The cervical sagittal parameters and demographics did not exhibit significant intergroup differences. Multivariate logistic regression analysis revealed that higher preoperative FJD grade was associated with postoperative severe neck pain ( P =0.046). In addition, lesser preoperative C2-C7 extension capacity was identified as a factor influencing postoperative kyphosis ( P =0.027).

Conclusions: This study demonstrates that patients with higher preoperative FJD are more likely to experience postoperative severe neck pain. However, it did not find an association between FJD and postlaminoplasty kyphosis, indicating that FJD does not influence cervical alignment aggravation.

Level of evidence: Level III.

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椎板成形术后颈部疼痛和后凸改变是否受小关节退变程度的影响？

研究设计：回顾性队列研究。目的：到目前为止，椎板成形术后颈部疼痛或后凸与小关节退变（FJD）之间的关系尚不清楚。因此，本研究旨在确定FJD是否影响椎板成形术后颈部疼痛或后凸。背景资料总结：FJD可引起内侧分支刺激，导致椎板成形术后颈部疼痛。颈椎前凸是椎板成形术的先决条件，因为它通过后移位实现脊髓减压。方法：本研究纳入126例连续行椎板成形术的患者，随访至少2年。评估颈椎矢状面影像学参数、颈部疼痛视觉模拟评分（VAS）、手臂疼痛模拟评分（VAS）、颈部残疾指数（NDI）和日本骨科协会评分。比较中重度颈部疼痛患者(颈部疼痛VAS≥4；颈部疼痛VAS结果：轻度和重度颈部疼痛组分别为99例（78.6%）和27例（21.4%）。重度颈痛组术前FJD程度明显高于重度颈痛组（P=0.040）。颈椎矢状面参数和人口统计学在组间无显著差异。多因素logistic回归分析显示术前FJD分级高与术后重度颈痛相关（P=0.046）。此外，术前较小的C2-C7伸展能力被认为是影响术后后凸的因素（P=0.027）。结论：本研究表明术前FJD较高的患者术后更容易出现严重的颈部疼痛。然而，没有发现FJD与椎板成形术后后凸之间的关联，这表明FJD不影响颈椎直线加重。证据等级：三级。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.