Lee Dong-Ho, Cagulada Arnold Joseph P, Hwang Chang Ju, Cho Jae Hwan, Park Sehan
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Governor Celestino Gallares Memorial Medical Center, Tagbilaran City, Philippines.
Global Spine J. 2025 Jan 15:21925682251314490. doi: 10.1177/21925682251314490.
Retrospective cohort study.
To (1) determine whether preoperative neck pain improves after laminoplasty for cervical myelopathy and identify factors that could predict improvements in neck pain.
A total of 88 patients with preoperative neck pain visual analogue scale (VAS) of ≥4, who underwent laminoplasty for cervical myelopathy, and were followed-up for >2 years were retrospectively reviewed. Patients demonstrating ≥50% improvement in VAS scores for neck pain 2 years postoperatively compared toㅇ preoperative assessment were included in neck pain improved (NP-improved) group. The remaining patients were assigned to neck pain unimproved (NP-unimproved) group.
Overall, 54 patients (61.4%) were included in NP-improved group and 34 patients (38.6%) were included in NP-unimproved group. NP-unimproved group more frequently underwent C3 laminectomy ( = 0.026) and had lesser degree of preoperative C2-C7 lordosis ( = 0.006) in the extension position compared to that in the NP-improved group. Furthermore, undergoing C3 laminectomy was associated with lower probability of achieving a ≥50% improvement in neck pain VAS scores ( = 0.018), while greater preoperative C2-C7 lordosis in the extension position was associated with a higher possibility of neck pain improvement ( = 0.048). A cut-off value of 20.5° for C2-C7 lordosis in the extension position predicted a ≥50% improvement in neck pain.
Preoperative neck pain should not be considered contraindication for laminoplasty as 61.4% of patients experienced ≥50% improvement in neck pain post-operatively. C3 laminectomy decreases the probability of neck pain improvement after laminoplasty, while greater C2-C7 lordosis in the extension position is associated with neck pain improvement.
回顾性队列研究。
（1）确定颈椎脊髓病行椎板成形术后术前颈部疼痛是否改善，并确定可预测颈部疼痛改善的因素。
回顾性分析88例术前颈部疼痛视觉模拟量表（VAS）≥4分、因颈椎脊髓病接受椎板成形术且随访时间>2年的患者。术后2年颈部疼痛VAS评分较术前评估改善≥50%的患者纳入颈部疼痛改善（NP改善）组。其余患者分配至颈部疼痛未改善（NP未改善）组。
总体而言，NP改善组纳入54例患者（61.4%），NP未改善组纳入34例患者（38.6%）。与NP改善组相比，NP未改善组更频繁地进行C3椎板切除术（P = 0.026），且伸展位术前C2-C7前凸程度较小（P = 0.006）。此外，进行C3椎板切除术与颈部疼痛VAS评分改善≥50%的可能性较低相关（P = 0.018），而伸展位术前C2-C7前凸程度较大与颈部疼痛改善的可能性较高相关（P = 0.048）。伸展位C2-C7前凸的临界值为20.5°可预测颈部疼痛改善≥50%。
术前颈部疼痛不应被视为椎板成形术的禁忌证，因为61.4%的患者术后颈部疼痛改善≥50%。C3椎板切除术会降低椎板成形术后颈部疼痛改善的概率，而伸展位较大的C2-C7前凸与颈部疼痛改善相关。
