The comparison of postoperative axial pain after unilateral laminoplasty combined with different fixations for treating ossification of cervical posterior longitudinal ligament
Gong Teng*, Su Xuetao, Xia Qun, Wang Jinggui
*Department of Orthopaedic Surgery, the Affiliated Hospital of Logistics College of Chinese People's Armed Police Force, Tianjin 300162,China
Abstract：Objective To analyze the influence from preoperative instability and intraoperative different internal appliances on union rate of hinge trough and characteristics of postoperative axial pain(PAP) after decompression of unilateral expansive laminoplasty for patients with multilevel ossification of cervical posterior longitudinal ligament(OPLL).Methods From January 2010 to April 2014, the study retrospectively reviewed 106 OPLL patients who underwent unilateral laminoplasty supplemented by continuous mini-plates or pedicular screws fixation with a minimum of 36 months of follow-up. According to complicated with preoperatively cervical instability or not, the sufferers were divided into cervical steadiness group and unsteadiness group. Subsequently, every group was divided into fixation of mini-plate and transpedicular screw subgroups in terms of instrumentation types. Thirty-six cases of preoperative instability comprised of 22 cases of pedicle fixation and 14 cases of mini-plates. Seventy cases of preoperative stability included 17 cases of pedicle fixation and 53 cases of mini-plate. The prevalence, initial onset, severity, duration of PAP and union rate of hinge groove at postoperative 3 months were compared to analyze the influence of two internal methods and preoperative unsteadiness on features of PAP.Results Significantly statistic difference in incidence of PAP between preoperative unsteadiness group(27.78%, 10/36) and steadiness group(11.43%, 8/70) existed(χ2=4.516, P<0.05). Without the condition of preoperatively cervical instability, fusion rate of hinge groove in pedicle group was higher than that in mini-plate group, the P value reached significantly statistic difference(t=2.995, P<0.05).Duration of PAP in pedicle group appeared to be shorter than that in mini-plate group, the difference reached statistic significance(t=11.450, P<0.05).There were no significantly statistic differences in other parameters between two subgroups respectively(P>0.05).With the state of preoperative instability, incidence of PAP in pedicle group was lower in comparison of that in mini-plate group, the difference achieved statistic significance(χ2=9.841, P=0.042). There were no significantly statistic differences in other index between two subgroups respectively(all P values>0.05).Conclusions Pedicle fixation is prone to reducing incidence of PAP in contrast to mini-plate fixation to some extent under the condition of preoperative instability which tends to induce occurrence of PAP.The study suggests that pedicular fixation will be beneficial to improving and promoting fusion ratio of hinge groove and shortening duration period of PAP under the condition of cervical stability.
巩腾, 苏学涛, 夏群, 王景贵. 椎管成形辅助不同内固定术治疗颈椎后纵韧带骨化症的术后轴性痛对比分析[J]. 中华解剖与临床杂志, 2018, 23(1): 45-51.
Gong Teng, Su Xuetao, Xia Qun, Wang Jinggui. The comparison of postoperative axial pain after unilateral laminoplasty combined with different fixations for treating ossification of cervical posterior longitudinal ligament. Chinese Journal of Anatomy and Clinics, 2018, 23(1): 45-51.
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2018, Vol. 23 
