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 : 2025-03-31 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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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.