Evaluation of Haplo-Paraspinal-Muscle-Preserving Technique to Prevent Postoperative Axial Pain in Cervical Laminoplasty

XiaoLong Shen; Chen Xu; Ruizhe Wang; Zifan Zhang; Min Qi; Yizhi Zhang; Huiqiao Wu; Yang Liu; Huajiang Chen; Wen Yuan

doi:10.14444/8416

Evaluation of Haplo-Paraspinal-Muscle-Preserving Technique to Prevent Postoperative Axial Pain in Cervical Laminoplasty

Int J Spine Surg. 2023 Apr;17(2):281-291. doi: 10.14444/8416. Epub 2023 Jan 12.

Authors

XiaoLong Shen^#¹, Chen Xu^#¹, Ruizhe Wang^#¹, Zifan Zhang^#¹, Min Qi¹, Yizhi Zhang¹, Huiqiao Wu¹, Yang Liu¹, Huajiang Chen², Wen Yuan²

Affiliations

¹ Spine Center, Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
² Spine Center, Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China yuanwenspine@smmu.edu.cn chen.spine@163.com.

^# Contributed equally.

PMID: 36635065
PMCID: PMC10165665
DOI: 10.14444/8416

Abstract

Background: The present study aimed to assess the efficacy of a new haplo-paraspinal-muscle-preserving (HMP) laminoplasty technique in the treatment of cervical myelopathy.

Methods: The medical records of 68 patients diagnosed with multisegmental cervical myelopathy were retrospectively reviewed. Of these, 22 patients who underwent HMP laminoplasty were defined as the muscle-preserved group (MP), and 46 patients who underwent traditional open-door laminoplasty were enrolled and defined as the traditional open-door laminoplasty group (LP). Patient demographic data and surgical parameters like clinical and radiological parameters, operation duration, blood loss, and spinal canal expansion distance were compared.

Results: Average surgical time and blood loss were significantly reduced in the MP group when compared with the LP group (P < 0.05). Both groups demonstrated significant improvements in neurological function and spinal canal expansion (P > 0.05). However, the visual analog scale score in the MP group was significantly lower compared with the LP group at the 6-month follow-up (P < 0.05), but no differences were found at the 1-year follow-up. The loss of lordosis was more prominent in the LP group when compared with the MP group at 1-year follow-up (P < 0.05). Lower events of persistent axial pain were found in the MP group but with no statistical significance. More hinge side laminae fractures could be found in the MP group, but more hinge side displacements were found in the LP group.

Conclusions: The HMP laminoplasty technique is relatively safe, effective, easier to perform, and better for lordosis maintenance and complication control compared with the traditional open-door technique.

Clinical relevance: Although traditional open-door laminoplasty is an efficient approach in treating multisegmental cervical myelopathy, the complications could significantly affect the clinical outcome. Our new HMP laminoplasty technique has a lower complication rate and a better lordosis maintenance ability; therefore, it could be a better choice in treating multisegmental cervical myelopathy.

Keywords: axial pain; cervical myelopathy; laminoplasty; paraspinal muscle.

This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.