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An influence on postoperative axial pain by laminoplasty combined with different fixations and bone grafting / 中国组织工程研究
Chinese Journal of Tissue Engineering Research ; (53): 1493-1498, 2018.
Article in Chinese | WPRIM | ID: wpr-698567
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.
Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Tissue Engineering Research Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Tissue Engineering Research Year: 2018 Type: Article