Shigeto Ebata1, Hirokazu Sato2, Tetsuro Ohba1, Takashi Ando1, Hirotaka Haro1. 1. Department of Orthopaedic Surgery, University of Yamanashi, Yamanashi, Japan. 2. Department of Orthopaedic Surgery and Spine Center, Saiseikai Kawaguchi General Hospital, Saitama, Japan.
Abstract
BACKGROUND: We previously demonstrated short length of rest with a cervical orthosis obtained a decreased tendency for neck or shoulder pain, neck stiffness, and impairment of cervical alignment after cervical laminoplasty. Postoperative maintenance of cervical motion may result in intervertebral instability and poor surgical outcomes. OBJECTIVE: The purpose of this study was to compare the postoperative fusion rate, range of motion (ROM), vertebral listhesis, and surgical outcomes with the duration of rest with a cervical orthosis. METHODS: We conducted cervical laminoplasty on 66 patients with spondylotic myelopathy. All patients were followed for at least two years. Patients remained in bed for two weeks and wore a cervical orthosis for eight weeks postoperatively, postoperative bed rest for seven days and use of an orthosis for four weeks, or postoperative bed rest for five days followed by use of an orthosis for two weeks were assigned. RESULTS: Long rest with a cervical orthosis produced multiple unions and limitation of cervical ROM, resulting in postoperative neck pain. Short rest maintained motion at multiple disc levels. There was no marked difference in neurogenic outcomes between short and long rest. CONCLUSIONS: A short rest period with a cervical orthosis is recommended to maintain cervical motion free from neck pain.
BACKGROUND: We previously demonstrated short length of rest with a cervical orthosis obtained a decreased tendency for neck or shoulder pain, neck stiffness, and impairment of cervical alignment after cervical laminoplasty. Postoperative maintenance of cervical motion may result in intervertebral instability and poor surgical outcomes. OBJECTIVE: The purpose of this study was to compare the postoperative fusion rate, range of motion (ROM), vertebral listhesis, and surgical outcomes with the duration of rest with a cervical orthosis. METHODS: We conducted cervical laminoplasty on 66 patients with spondylotic myelopathy. All patients were followed for at least two years. Patients remained in bed for two weeks and wore a cervical orthosis for eight weeks postoperatively, postoperative bed rest for seven days and use of an orthosis for four weeks, or postoperative bed rest for five days followed by use of an orthosis for two weeks were assigned. RESULTS: Long rest with a cervical orthosis produced multiple unions and limitation of cervical ROM, resulting in postoperative neck pain. Short rest maintained motion at multiple disc levels. There was no marked difference in neurogenic outcomes between short and long rest. CONCLUSIONS: A short rest period with a cervical orthosis is recommended to maintain cervical motion free from neck pain.