術後頸椎機能回復における術前頸椎機能の影響
Zhiliang Zhang1, Yi Zhao2, Hu Zhao1
1Department of Rehabilitation, Peking University Third Hospital, Peking University, Beijing, China.
Background:
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.
Methods:
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).
Results:
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).
Conclusion:
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.
