A Modified Open-Door Laminoplasty with Reconstruction of the Cervical Posterior Ligamental Complex to Decrease Axial Pain in Cervical Spondylotic Myelopathy

Background: Cervical spondylotic myelopathy patients with multiple segments are usually treated with surgery via the posterior approach, but expansive open laminoplasty (ELAP) often results in heavy, rigid, and acid bilge feelings in the neck, shoulder, and back, collectively known as axial symptoms. Objective: To evaluate the effect of modified posterior cervical ligament complex reconstruction and single-door laminoplasty with titanium plate fixation on postoperative axial symptoms in patients. Methods: : We conducted a retrospective study including 132 cases of cervical spondylotic myelopathy at our institute from June 2016 to March 2018. Gender, age, operation time, intraoperative blood loss, post-operative drainage volume, and follow-up time, Visual analogue scoring (VAS), cervical curvature index (CCI) and the cross-sectional area of the posterior cervical muscles of the two groups were recorded. Results: : There was statistical significance in the incidence of axial pain 3 months after surgery ( P = 0.001), 6 months after surgery ( P = 0.006), and 1 year after surgery ( P = 0.015). Compared to group b, the VAS score in group A was decreased 1 week ( P <0.0001), one month, 3 months ( P =0.0001), 6 months( P =0.0076), and 1 year( P =0.0085) after surgery. The CCI and the posterior cervical muscle area also differed significantly between the two groups ( P < 0.0001). Conclusion: Modified single open-door laminoplasty could relieve cervical axial pain in patients with cervical spondylotic myelopathy.