The new proposal of the relationship between axial pain and hinge fracture and facet involvement after open-door laminoplasty with titanium spacers

Abstract

This was a retrospective, observational study. OBJECTIVES: Postoperative axial pain (AP) is a well-known complication of cervical posterior surgery. It can be caused by various reasons, but the etiology remains unclear. This study aimed to investigate risk factors for postoperative AP after open-door laminoplasty. A previous meta-analysis revealed muscle damage, female, age of 1 month postoperatively. We compared the demographic and radiographic characteristics of AP and non-AP groups. Results: Postoperative AP developed in 62 (48.1%) patients. Intraoperative hinge fracture (HF) and facet involvement by miniscrews were significantly greater in the AP group than in the non-AP group (P < 0.05). Using a logistic regression model, multivariate analysis revealed that HF was significantly associated with postoperative AP (odds ratio = 2.83, 95% confidence interval = 1.28–6.44, P = 0.011). Conclusions: HF and facet involvement were risk factors for postoperative AP after open-door laminoplasty with titanium spacers. Careful surgical manipulation is required to prevent postoperative AP.

Keywords

• axial pain
• cervical laminoplasty
• facet involvement
• hinge fracture
• open door