Changes in Neck Range of Motion After Laminoplasty Based on Cervical Foraminal Stenosis.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-08-01 DOI:10.1097/BSD.0000000000001794

Woo-Seok Jung, Jae-Won Shin, Yung Park, Joong-Won Ha, Hak Sun Kim, Kyung-Soo Suk, Sung-Hwan Moon, Si-Young Park, Byung-Ho Lee, Ji-Won Kwon, Sung-Woo Lee

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引用次数: 0

Abstract

Study design: Retrospective study.

Objective: To investigate the relationship between a number of preoperative cervical foraminal stenoses and postoperative ROM in cervical laminoplasty patients.

Summary of background data: Several concerns exist, such as upper extremity palsy, kyphosis, axial neck pain, and ROM changes after laminoplasty. Preoperative foraminal stenosis is a known risk factor for upper extremity palsy and kyphosis after laminoplasty.

Methods: Open-door laminoplasty patients with cervical myelopathy between January 2007 and September 2021 were included. Foraminal stenosis was evaluated using MRI T2-weighted images of the axial cut. The number of foraminal stenoses was counted among 10 foramina from C3/C4 to C7/T1, and the study population was divided into 2 groups based on the number of foraminal stenoses. Groups A and B comprised individuals with <4 and 4 or more foraminal stenoses, respectively. ROM was measured through flexion and extension view plain lateral radiography using Cobb method. NDI and VAS scores were used to assess clinical symptoms. Cervical spondylosis was assessed with Cervical Degenerative Index (CDI) factor scoring system. Statistical analyses were performed using 2-sample t test, χ 2 test, and linear mixed model.

Results: Sixty-three patients (group A, 27; group B, 36) were analyzed. NDI score after 1 year was 18.33 and 19.29 in groups A and B ( P =0.027). Regarding neck pain, VAS score after 3 years of surgery was 1.55 in group A and 3.94 in group B ( P =0.043). Flexion and total ROM in group A, 3 years post-surgery were 24.59 and 36.2 degrees, and group B had values of 16.04 and 24.98 degrees, respectively ( P =0.014). Three years after surgery, ROM preservation ratio was 89% in group A and 66% in group B ( P =0.013). On the basis of the CDI factor scoring system, difference of average between groups was 1.02 ( P =0.081).

Conclusions: A greater number of foraminal stenoses results in a reduction in ROM after laminoplasty.

Level of evidence: Level III.

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颈椎椎间孔狭窄椎板成形术后颈部活动范围的变化。

研究设计：回顾性研究。目的：探讨颈椎椎板成形术患者术前椎间孔狭窄与术后ROM的关系。背景资料总结：存在一些问题，如上肢麻痹、后凸、轴向颈痛和椎板成形术后ROM改变。术前椎间孔狭窄是椎管成形术后上肢瘫痪和后凸的已知危险因素。方法：纳入2007年1月至2021年9月期间颈椎椎板成形术患者。椎间孔狭窄采用轴向切口的MRI t2加权图像进行评估。统计从C3/C4到C7/T1的10个椎间孔狭窄的数量，根据椎间孔狭窄的数量将研究人群分为2组。结果：63例患者(A组27例；B组36例)。A组和B组1年后NDI评分分别为18.33分和19.29分（P=0.027）。术后3年颈部疼痛VAS评分A组为1.55分，B组为3.94分（P=0.043）。A组术后3年屈曲度和总ROM分别为24.59度和36.2度，B组术后3年屈曲度和总ROM分别为16.04度和24.98度（P=0.014）。术后3年，A组ROM保存率89%，B组66% （P=0.013）。采用CDI因子评分系统，两组间平均差异为1.02 （P=0.081）。结论：椎间孔狭窄的增多导致椎板成形术后ROM的减少。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.