An influence on postoperative axial pain by laminoplasty combined with different fixations and bone grafting

doi:10.3969/j.issn.2095-4344.0701

Abstract

Abstract:

BACKGROUND: In clinical practice, inducible grafting from trimmed spinous process of hinge groove combined with different internal fixators is primarily applied to prevent postoperative axial pain after unilateral open-door cervical expansive laminoplasty.

OBJECTIVE: To investigate the influence of autologous grafting of hinge groove combined with two internal fixators on postoperative axial pain after unilateral open-door cervical expansive laminoplasty.

METHODS: We retrospectively reviewed 106 patients with multilevel ossification of cervical posterior longitudinal ligament who had underwent unilateral open-door cervical expansive laminoplasty with pedicle screw fixation (n=52, including grafting in 24 cases and non-grafting in 28 cases) or with mini-plate fixation (n=54, including grafting in 37 cases and non-grafting in 17 cases). Fusion rate of hinge groove, characteristics of postoperative axial pain and postoperative efficacy were evaluated by means of imaging methods.

RESULTS AND CONCLUSION: All the 106 patients were followed up for 3.2-5.9 years, with no appearance of breaking or loosening of fixed appliances, disruption of the interior cortex of hinge groove. The 19 of 106 cases appeared to have postoperative axial pain, including 9 cases in the pedicle screw group (grafting: 4 cases, non-grafting: 5 cases) and 10 cases in the mini-plate group (grafting: 3 cases, non-grafting: 7 cases). Under the condition of pedicle screw fixation, there were no significant differences in the fusion rate at 3 months postoperatively and improvement rate of Japanese Orthopaedic Association Scale (JOA) score at final follow-up between the grating and non-grafting groups. After the implementation of mini-plate fixation, there was also no difference in JOA improvement rate at final follow-up between the grafting and non-grafting groups, but the fusion rate in the grafting group was significantly higher than that in the non-grafting group at 3 months postoperatively (P < 0.05). After pedicle screw fixation, there was no significant difference in incidence, onset time and severity of initial onset, duration, pain improvement between grafting and non-grafting groups. When fixed by mini-plates, pain duration and pain improvement

were better in the grafting group than the non-grafting group (P < 0.05), and there were still no significant differences in the other indices between the two groups. To conclude, hinge grafting combined with pedicle screw fixation cannot affect onset characteristics of postoperative axial pain, while hinge grafting combined with mini-plate fixation can reduce duration of postoperative axial pain, improve prognosis, promote definite fusion of hinge groove, thereby remodeling alignment balance and biomechanical stability as soon as possible．

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Internal Fixators, Bone Transplantation, Spinal Fusion, Tissue Engineering

CLC Number:

R318

Gong Teng, Su Xue-tao, Xia Qun, Wang Jing-gui, Kan Shi-lian. An influence on postoperative axial pain by laminoplasty combined with different fixations and bone grafting[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(10): 1493-1498.

Figures/Tables 6

References

[1]刘晓伟,陈德玉,王新伟,等.颈椎后纵韧带骨化症患者K线对两种颈后路手术疗效的影响[J].中国脊柱脊髓杂志,2013,23(1):6-10.

[2]陈华,刘浩,李涛,等.微型钢板侧块螺钉穿透小关节面对颈椎单开门术后轴性症状的影响[J].中国修复重建外科杂志,2013,27(11):

1324-1330.

[3]Kawaguchi Y,Nagami S,Nakano M,et al.Relationship between postoperative axial symptoms and the rotational angle of the cervical spine after laminoplasty.Eur J Orthop Surg Traumatol.

2013;12(Suppl1):53-58.

[4]Chen H,Liu H,Deng YX,et al.Multivariate analysis of factors associated with axial symptoms in unilateral expansive open-door cervical laminoplasty with miniplate fixation.Medicine.2016; 95(2):

1-8.

[5]张学利,夏英鹏,贾宇涛,等.Fastin锚钉在颈椎单开门椎管成形术中的应用[J].中国矫形外科杂志,2009,17(4):256-259.

[6]Chang H,Baek DH,Choi BW.The relationship between increased intervertebral disc height and development of postoperative axial neck pain after anterior cervical fusion.J Korean Neurosurg.2014;

55(6):343-347.

[7]Ding HR,Xue Y,Tang YM,et al.Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study.PloS One.2014;9(4):95482-95490.

[8]Wei D,Wang LF,Shen Y,et al.Long-term impacts of different posterior operations on curve,neurological recovery and axial symptoms for multilevel cervical degenerative myelopathy.Eur Spine J.2013;4(1):42-53.

[9]Fujimori T,Le H,Ziewacz JE,et al.Is there a difference in range of motion, neck pain, and outcomes in patients with ossification of posterior longitudinal ligament versus those with cervical spondylosis, treated with plated laminoplasty? Neurosurg Focus. 2013;35(1):1394-1402.

[10]Mitsunaga LK,Klineberg EO,Gupta MC.Laminoplasty techniques for the treatment of multilevel cervical stenosis.Adv Orthop.2012;

20(12):307916-307930.

[11]Riew KD,Raich AL,Dettori JR,et al.Neck pain following cervical laminoplasty : Does preservation of the C2 muscle attachment and/or C7 matter? Evid Based Spine Care J.2013;4(1):42-53.

[12]Wang SJ,Jiang SD,Jiang LS,et al.Axial pain after posterior cervical spine surgery: a systematic review.Eur Spine J.2011;

20(2):185-194.

[13]席焱海,何海龙,余将明,等.颈椎后路ARCH椎板成形系统联合选择性侧块螺钉固定术治疗伴短节段不稳的多节段颈椎病[J].脊柱外科杂志,2016,14(6):325-329.

[1]	Zhang Tongtong, Wang Zhonghua, Wen Jie, Song Yuxin, Liu Lin. Application of three-dimensional printing model in surgical resection and reconstruction of cervical tumor [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1335-1339.
[2]	Zeng Yanhua, Hao Yanlei. In vitro culture and purification of Schwann cells: a systematic review [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(7): 1135-1141.
[3]	Xu Dongzi, Zhang Ting, Ouyang Zhaolian. The global competitive situation of cardiac tissue engineering based on patent analysis [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(5): 807-812.
[4]	Wu Zijian, Hu Zhaoduan, Xie Youqiong, Wang Feng, Li Jia, Li Bocun, Cai Guowei, Peng Rui. Three-dimensional printing technology and bone tissue engineering research: literature metrology and visual analysis of research hotspots [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 564-569.
[5]	Chang Wenliao, Zhao Jie, Sun Xiaoliang, Wang Kun, Wu Guofeng, Zhou Jian, Li Shuxiang, Sun Han. Material selection, theoretical design and biomimetic function of artificial periosteum [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 600-606.
[6]	Liu Fei, Cui Yutao, Liu He. Advantages and problems of local antibiotic delivery system in the treatment of osteomyelitis [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 614-620.
[7]	Li Xiaozhuang, Duan Hao, Wang Weizhou, Tang Zhihong, Wang Yanghao, He Fei. Application of bone tissue engineering materials in the treatment of bone defect diseases in vivo [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 626-631.
[8]	Zhang Zhenkun, Li Zhe, Li Ya, Wang Yingying, Wang Yaping, Zhou Xinkui, Ma Shanshan, Guan Fangxia. Application of alginate based hydrogels/dressings in wound healing: sustained, dynamic and sequential release [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 638-643.
[9]	Chen Jiana, Qiu Yanling, Nie Minhai, Liu Xuqian. Tissue engineering scaffolds in repairing oral and maxillofacial soft tissue defects [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 644-650.
[10]	Xing Hao, Zhang Yonghong, Wang Dong. Advantages and disadvantages of repairing large-segment bone defect [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(3): 426-430.
[11]	Zeng Xianghong, Liang Bowei. A new strategy for the treatment of osteonecrosis of the femoral head [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(3): 431-437.
[12]	Tang Xiaokai, Li Weiming. Role and mechanism of Nel-like molecule-1 in promoting bone fusion after spinal fusion [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(24): 3914-3920.
[13]	Chen Siqi, Xian Debin, Xu Rongsheng, Qin Zhongjie, Zhang Lei, Xia Delin. Effects of bone marrow mesenchymal stem cells and human umbilical vein endothelial cells combined with hydroxyapatite-tricalcium phosphate scaffolds on early angiogenesis in skull defect repair in rats [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(22): 3458-3465.
[14]	Wang Hao, Chen Mingxue, Li Junkang, Luo Xujiang, Peng Liqing, Li Huo, Huang Bo, Tian Guangzhao, Liu Shuyun, Sui Xiang, Huang Jingxiang, Guo Quanyi, Lu Xiaobo. Decellularized porcine skin matrix for tissue-engineered meniscus scaffold [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(22): 3473-3478.
[15]	Mo Jianling, He Shaoru, Feng Bowen, Jian Minqiao, Zhang Xiaohui, Liu Caisheng, Liang Yijing, Liu Yumei, Chen Liang, Zhou Haiyu, Liu Yanhui. Forming prevascularized cell sheets and the expression of angiogenesis-related factors [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(22): 3479-3486.