Impacto de la función de la columna cervical preoperatoria en la rehabilitación funcional postoperatoria en pacientes...

Laminoplasty has been widely used for the treatment of multilevel degenerative cervical myelopathy (DCM). However, patients often experience persistent axial symptoms, which affect post-operative functional rehabilitation. This study aims to explore the intrinsic connection between the pre-operative structural and functional status of the cervical spine and the post-operative functional rehabilitation of patients undergoing laminoplasty, providing a theoretical basis for individualized rehabilitation strategies for specific populations.

A retrospective analysis was conducted on the clinical data of patients who underwent laminoplasty and received inpatient rehabilitation treatment. Pre-operative and 3-month post-operative visual analog scale (VAS) score, modified Japanese orthopedic association (mJOA) score, and neck disability index (NDI) score were collected, and correlation analyses were performed with pre-operative cervical flexion and extension range of motion (ROM), cervical muscle strength, and the functional cross-sectional area (fCSA) of posterior cervical muscles measured by magnetic resonance imaging (MRI).

Among the 30 included patients, 17 were males and 13 were females with an average age of 59.70 ± 8.41 years, the follow-up period is 3 months. Correlation analysis revealed that pre-operative cervical extension muscle strength was weakly positively correlated with the post-operative VAS score (r = 0.364, p = 0.048) and was moderately positively correlated with the NDI score (r = 0.448, p = 0.013). The regression analysis results showed that extension strength had a significant and positive independent predictive effect on post-operative VAS score (β = 0.256, p = 0.025) and NDI score (β = 0.789, p = 0.024). For the sum of posterior cervical muscles, pre-operative fCSA of the right multifidus (MF) was weakly negatively correlated with the post-operative NDI score (r = -0.369, p = 0.045).

Our result suggested that stronger pre-operative cervical extension strength may be important predictors of post-operative functional rehabilitation in patients after laminoplasty, especially in terms of axial symptoms.