Comparison of Axial Symptoms and Limitations of Activities of Daily Living Accompanying Reduced Neck Mobility After Cervical Laminoplasty Preserving C2 Muscle Attachments With and Without C2 to T1 Instrumented Fusion.

Abstract

ObjectiveMuscles are usually detached from C2 to facilitate C2 pedicle screw insertion. The aim of this study was to compare 1-year postoperative axial symptoms and limitations in activities of daily livings (ADLs) accompanying reduced neck mobility between 2 procedures in which all C2 muscle attachments are preserved: laminoplasty and C2 to T1 fusion (LPF group: n=15) and laminoplasty alone (LP group: n=26). MethodsWe examined axial symptoms and limitations in ADLs using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire. We also examined related factors, including the occiput (O)–C7 angle in extension and flexion, and the rotational and O–C2 ranges of motion (ROM). ResultsThe postoperative decreases in the O–C7 angle in flexion (27.8° vs. 9.4°) and rotational ROM (40° vs. 15°), as well as the compensating postoperative increase in the O–C2 ROM (11.7° vs. 2.3°), were significantly greater in the LPF group. Most of the axial symptoms were similar between groups. The ability to perform ADLs tended to worsen more frequently in the LPF group, but the difference did not achieve significance. ConclusionPostoperative changes in axial symptoms and loss of ROM were not obstacles affecting patients’ ability to perform ADLs after laminoplasty with muscle-sparing C2 to T1 fusion.