Axial neck pain after cervical laminoplasty.
OBJECTIVE
It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty.


METHODS
A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n = 16) and in patients in which the C7 spinous process was sacrificed (group 2, n = 15).


RESULTS
Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p = 0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p = 0.002).


CONCLUSIONS
The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.
Catholic Neuroscience Center, Department of Neurosurgery, St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea.
Chul Bum
CB
Cho
Chung Kee
CK
Chough
Jong Yang
JY
Oh
Hae Kwan
HK
Park
Kyung Jin
KJ
Lee
Hyoung Kyun
HK
Rha
Axial neck pain; C7 spinous process; Cervical laminoplasty