医学
椎板成形术
颈部疼痛
可视模拟标度
运动范围
颈领
随机对照试验
脊髓病
外科
颈椎
衣领
颈椎
脊髓
病理
替代医学
工程类
精神科
机械工程
作者
Jason Pui Yin Cheung,Karlen Ka Pui Law,Vishal Borse,Yuk Ming Lau,Ling Fung Mak,Aldous Cheng,Dino Samartzis,Kenneth Man Chee Cheung
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2018-08-03
卷期号:85 (3): 325-334
被引量:18
标识
DOI:10.1093/neuros/nyy359
摘要
Abstract BACKGROUND Cervical collars are used after laminoplasty to protect the hinge opening, reduce risks of hinge fractures, and avoid spring-back phenomena. However, their use may lead to reduced range of motion and worse neck pain. OBJECTIVE To investigate the clinical, radiological, and functional outcomes of patients undergoing single-door laminoplasty with or without collar immobilization. METHODS This was a prospective, parallel, single-blinded randomized controlled trial. Patients underwent standardized single-door laminoplasty with mini-plates for cervical myelopathy and were randomly allocated into 2 groups based on the use of collar postoperatively. Clinical assessments included cervical range of motion, axial neck pain (VAS [visual analogue scale]), and objective scores (short-form 36-item, neck disability index, and modified Japanese Orthopaedic Association). All assessments were performed preoperatively and at postoperative 1, 2, 3, and 6 wk, and 3, 6, and 12 mo. Comparative analysis was performed via analysis of variance adjusted by baseline scores, sex, and age as covariates. RESULTS A total of 35 patients were recruited and randomized to collar use (n = 16) and without (n = 19). There were no dropouts or complications. There were no differences between groups at baseline. Subjects had comparable objective scores and range of motion at postoperative time-points. Patients without collar use had higher VAS at postoperative 1 wk (5.4 vs 3.5; P = .038) and 2 wk (3.5 vs 1.5; P = .028) but subsequently follow-up revealed no differences between the 2 groups. CONCLUSION The use of a rigid collar after laminoplasty leads to less axial neck pain in the first 2 wk after surgery. However, there is no additional benefit with regards to range of motion, quality of life, and complication risk.
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