Oshima Yasushi, Matsubayashi Yoshitaka, Taniguchi Yuki, Hayakawa Kentaro, Fukushima Masayoshi, Oichi Takeshi, Oka Hiroyuki, Riew K Daniel, Tanaka Sakae
The University of Tokyo, Tokyo, Japan.
Columbia University, New York, NY, USA.
Global Spine J. 2019 May;9(3):292-297. doi: 10.1177/2192568218793861. Epub 2018 Aug 16.
A retrospective cohort study.
To investigate factors influencing the incidence of moderate to severe postoperative axial neck pain following cervical laminoplasty.
We reviewed 125 patients with cervical myelopathy who underwent double-door laminoplasty. The primary outcomes were the Numerical Rating Scale score (NRS score, 0-10) for neck pain, the Short Form 36 (SF-36) Health Survey score (Physical and Mental Component Summary scores [PCS and MCS, respectively]), and satisfaction. Imaging parameters on plain radiographs and magnetic resonance imaging were also evaluated. Patients with moderate to severe postoperative neck pain (NRS ≥ 5) were compared with those with no or mild neck pain (NRS ≤ 4).
One hundred and three patients (82%) with complete data were eligible for inclusion. There were 67 men and 36 women, with a mean age of 65 years (32-89 years). Twenty-five patients (23%) had moderate to severe postoperative axial pain (NRS ≥ 5) and were compared with the other 78 patients (NRS ≤ 4), which revealed several predictive factors, including female sex, the presence of preoperative neck pain, low postoperative PCS, low preoperative and postoperative MCS, and satisfaction with the treatment. Multivariable logistic regression analysis revealed that the postoperative MCS ( = .002) was a risk factor for postoperative neck pain, although the preoperative MCS did not reach statistical significance ( = .06).
Patients with a low mental state, possibly before surgery, are at a high risk for postoperative axial neck pain. None of the imaging parameters were statistically different.
一项回顾性队列研究。
探讨影响颈椎板成形术后中重度轴性颈部疼痛发生率的因素。
我们回顾了125例行双开门颈椎板成形术治疗颈椎病的患者。主要观察指标为颈部疼痛的数字评定量表评分（NRS评分，0 - 10分）、简明健康状况调查量表（SF - 36）评分（分别为生理和心理成分汇总评分[PCS和MCS]）以及满意度。还评估了X线平片和磁共振成像的影像学参数。将术后中重度颈部疼痛（NRS≥5）的患者与无或轻度颈部疼痛（NRS≤4）的患者进行比较。
103例（82%）有完整数据的患者符合纳入标准。其中男性67例，女性36例，平均年龄65岁（32 - 89岁）。25例（23%）患者术后出现中重度轴性疼痛（NRS≥5），将其与其他78例患者（NRS≤4）进行比较，发现了几个预测因素，包括女性、术前存在颈部疼痛、术后PCS低、术前和术后MCS低以及对治疗的满意度。多变量逻辑回归分析显示，术后MCS（P = 0.002）是术后颈部疼痛的危险因素，而术前MCS未达到统计学意义（P = 0.06）。
心理状态较差的患者，可能在手术前，术后发生轴性颈部疼痛的风险较高。影像学参数在统计学上无差异。
