Risk Factors Of Axial Symptoms After Cervical Open-Door Surgery

Objective: To investigate risk factors for developing axial symptoms(AS)after open-door laminoplasty in patients with degenerative cervical spine disease.Methods:Retrospective analysis was made on 90 patients who underwent posterior cervical open-door laminoplasty in our hospital from January 2019 to January 2021,including 67 males and 23 females,aged 38-84 years,with an average age of(61.63 ± 12.09)years.The patients were divided into AS group(32)and non AS group(58)according to whether AS occurred one month after operation.The age,gender,preoperative neck pain,preoperative JOA score,preoperative cervical curvature,disease duration,operative time,intraoperative blood loss,operative segment,angle of opening of the lamina,preoperative C2 SVA,postoperative C2 SVA,and wearing time of cervical collar were recorded for both groups.Univariate analysis was performed,and logistic multiple regression analysis was performed according to their outcomes,in turn,to analyze the risk factors for the development of AS after surgery.Results: 32 patients with AS,the incidence of AS is35.56%.Univariate analysis of the results showed that age,operation time,angle of opening of the lamina,preoperative C2 SVA,postoperative C2 SAV,and wearing time of cervical collar could be related to the occurrence of postoperative as(P <0.05).Multivariate logistic regression analysis revealed that a large postperative C2 SVA,a large intraoperative lamina opening angle,and a long wearing time of cervical collar were independent risk factors for the development of AS.Conclusion: The greater the postperative C2 SVA,the greater the opening angle of the vertebral lamina during the operation and the longer the wearing time of the neck bracket,the higher the incidence of AS.Therefore,it is necessary to control the opening angle of the vertebral lamina during the operation,shorten the wearing time of the cervical support after the operation,and move as early as possible to reduce the risk of AS,which is of extremely important to improve the quality of life of patients...