Are Postoperative Neck Pain and Kyphotic Change After Laminoplasty Affected by Degree of Facet Joint Degeneration?

Abstract

A retrospective cohort study. To date, the association between postlaminoplasty neck pain or kyphosis and facet joint degeneration (FJD) remains unknown. Therefore, this study aimed to determine whether FJD affects postlaminoplasty neck pain or kyphosis. FJD can cause medial branch irritation leading to postlaminoplasty neck pain. Cervical lordosis is a prerequisite for laminoplasty as it achieves cord decompression through posterior shifting. This study included 126 consecutive patients who underwent laminoplasty and were followed up for a minimum of 2 years. The radiographic cervical sagittal parameters, neck pain visual analog scale (VAS), arm pain VAS, neck disability index (NDI), and Japanese Orthopedic Association score were evaluated. A comparison was made between patients with moderate-to-severe neck pain (neck pain VAS ≥4; severe neck pain group) and those with mild or no neck pain (neck pain VAS <4; mild neck pain group) at the 2-year follow-up. Furthermore, patients who experienced postlaminoplasty kyphosis of C2-C7 (kyphotic group) were compared with those who did not develop kyphosis (nonkyphotic group). The mild and severe neck pain groups included 99 (78.6%) and 27 (21.4%) patients, respectively. The preoperative degree of FJD was significantly higher in the severe neck pain group ( P =0.040). The cervical sagittal parameters and demographics did not exhibit significant intergroup differences. Multivariate logistic regression analysis revealed that higher preoperative FJD grade was associated with postoperative severe neck pain ( P =0.046). In addition, lesser preoperative C2-C7 extension capacity was identified as a factor influencing postoperative kyphosis ( P =0.027). This study demonstrates that patients with higher preoperative FJD are more likely to experience postoperative severe neck pain. However, it did not find an association between FJD and postlaminoplasty kyphosis, indicating that FJD does not influence cervical alignment aggravation. Level III.