Cervical Pain After Cervical Laminoplasty: Causes and Treatments

Abstract

A number of studies have reported on the satisfactory results of cervical laminoplasty for cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) [1-4]. Because of its good results and low morbidity compared with anterior decompression surgery [5], laminoplasty has become the standard procedure for multisegmental cord compression in the cervical region. There is excellent neurological recovery after cervical laminoplasty, but many patients complain about postoperative neck pain or tension as well as shoulder stiffness. In the first report on axial pain, Hosono et al. [6] noted that 60% of patients suffered from neck and shoulder symptoms following unilateral open-type laminoplasty. In recent publications, there are few studies of patients’ postoperative complaints, although these report many examples of patients’ satisfaction with the treatment. Therefore, an open discussion about postoperational pain is needed. Complaints about postoperative neck troubles involve not only occasional discomfort, but also cases of pain or stiffness requiring regular massage, local injection therapy, or medication. Flexion of the cervical vertebrae aggravates the symptoms in many patients, hindering their ability to work for a long time at a desk, or even making it impossible to return to work. As most of the complaints involve patients’ own perception, their verification by an objective examination of symptoms is difficult.