Ito Sadayuki, Sakai Yoshihito, Ando Kei, Nakashima Hiroaki, Machino Masaaki, Segi Naoki, Tomita Hiroyuki, Koshimizu Hiroyuki, Hida Tetsuro, Ito Kenyu, Harada Atsushi, Imagama Shiro
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Asian Spine J. 2023 Apr;17(2):330-337. doi: 10.31616/asj.2022.0120. Epub 2023 Feb 6.
Retrospective study.
Cervical laminoplasty is safe and effective for treating cervical myelopathy but has a higher frequency of postoperative axial pain compared to other methods. Several studies have reported on the causes of postoperative axial pain, but none have fully elucidated them. This study aimed to investigate the association between postoperative neck pain and intraoperative transcranial motor-evoked potential (MEP) waveforms of the trapezius muscles using transcranial MEPs.
Few studies have investigated the association between postoperative neck pain and intraoperative transcranial MEP waveforms of the trapezius muscles in patients with cervical laminoplasty.
A total of 79 patients with cervical myelopathy who underwent cervical laminoplasty at our facility between June 2010 and March 2013 were included in this study. Intraoperative control and final waveform were evaluated based on the trapezius muscle MEPs by measuring the latency and amplitude. A neck pain group comprised patients with higher neck pain Visual Analog Scale scores from preoperative value to 1 year postoperatively. The cross-sectional areas of the trapezius muscles and the MEP latencies and amplitudes were compared between patients with and without neck pain.
The latency and amplitude of the control waveforms were not significantly different between groups. The neck pain group had a significantly shorter final waveform latency (neck pain: 23.6±2.5, no neck pain: 25.8±4.5; p =0.019) and significantly larger amplitude (neck pain: 2,125±1,077, no neck pain: 1,630±966; p =0.041) than the no neck pain group.
Postoperative neck pain was associated with the final waveform latency and amplitude of the trapezius muscle MEPs during cervical laminoplasty. Intraoperative electrophysiological trapezius muscle abnormalities could cause postoperative neck pain.
回顾性研究。
颈椎椎板成形术治疗脊髓型颈椎病安全有效，但与其他方法相比，术后轴性疼痛的发生率更高。多项研究报道了术后轴性疼痛的原因，但均未完全阐明。本研究旨在通过经颅运动诱发电位（MEP）研究颈椎椎板成形术患者术后颈部疼痛与术中斜方肌MEP波形之间的关系。
很少有研究调查颈椎椎板成形术患者术后颈部疼痛与术中斜方肌MEP波形之间的关系。
本研究纳入了2010年6月至2013年3月在我院接受颈椎椎板成形术的79例脊髓型颈椎病患者。通过测量潜伏期和波幅，基于斜方肌MEP评估术中对照和最终波形。颈部疼痛组包括术后1年颈部疼痛视觉模拟量表评分较术前值更高的患者。比较有颈部疼痛和无颈部疼痛患者的斜方肌横截面积、MEP潜伏期和波幅。
对照组波形的潜伏期和波幅在两组间无显著差异。颈部疼痛组的最终波形潜伏期显著短于无颈部疼痛组（颈部疼痛组：23.6±2.5，无颈部疼痛组：25.8±4.5；p =0.019），波幅显著大于无颈部疼痛组（颈部疼痛组：2125±1077，无颈部疼痛组：1630±966；p =0.041）。
颈椎椎板成形术期间，术后颈部疼痛与斜方肌MEP的最终波形潜伏期和波幅相关。术中斜方肌电生理异常可能导致术后颈部疼痛。
