Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis

Eur Spine J, 2008 · DOI: 10.1007/s00586-007-0553-1 · Published: November 24, 2007

Simple Explanation

This study investigates how different surgical techniques during cervical laminoplasty affect patients' ability to perform daily activities. The researchers compared two groups: one where a specific neck muscle (semispinalis cervicis) was preserved and another where it was reattached after surgery. They found that preserving the muscle led to fewer limitations in daily activities involving neck extension and rotation compared to reattaching it.

Study Duration

1 year and 8 months / 3 years and 2 months

Participants

Group A: 49 patients, Group B: 24 patients

Evidence Level

Not specified

Key Findings

1
The frequency of limitations of ADL accompanying extension was lower in Group A (2%) than in Group B (17%) (P = 0.037).
2
The frequency of limitations of ADL accompanying rotation was lower in Group A (12%) than in Group B (33%) (P = 0.031).
3
Average O–C7 angle at extension was significantly larger in Group A (147°) than in Group B (136°) (P = 0.002).

Research Summary

This retrospective study compared the frequency of limitations of ADL accompanying neck mobility after laminoplasty preserving the semispinalis cervicis inserted into the C2 spinous process with that after laminoplasty reattaching the muscle to C2. The study suggested that the frequency of limitations of ADL accompanying neck extension or rotation was lower after laminoplasty preserving the SSC inserted into C2 than after laminoplasty reattaching the muscle. Objective data showed that the postoperative O–C7 angles at extension or the rotation ROM in Group A were significantly larger than those in Group B, as if to corroborate the clinical data.

Practical Implications

Surgical Technique Optimization

Preserving the semispinalis cervicis muscle during laminoplasty may lead to better functional outcomes for patients, specifically in neck extension and rotation.

Rehabilitation Strategies

Post-operative rehabilitation should focus on regaining neck extension and rotation, especially in patients where the semispinalis cervicis muscle was reattached.

Patient Education

Patients undergoing cervical laminoplasty should be informed about the potential impact of different surgical techniques on their ability to perform daily activities.

Study Limitations

1
The frequency of limitation of ADL accompanying neck mobility after this modified laminoplasty preserving the SSC for patients with OPLL was not examined in the present study.
2
The average follow-up period of Group B was significantly longer than that of Group A.
3
After cervical laminoplasty, more than a few patients had limitations of ADL accompanying reduced neck mobility in the present study.

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