Impact of Preoperative Cervical Spine Function on Postoperative Functional Rehabilitation in Patients After Laminoplasty

Zhiliang Zhang¹Yi Zhao²Hu Zhao¹Mouwang Zhou¹Yanyan Yang¹Feifei Zhou²Zhiqian Luo²Junhao Tong²Guoqing Cui^1*Tao Li^3*

• ¹Peking University Third Hospital Department of Rehabilitation, Beijing, China
• ²Peking University Third Hospital Department of Orthopaedics, Beijing, China
• ³Peking University People's Hospital Department of Rehabilitation, 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 postoperative functional rehabilitation. This study aims to explore the intrinsic connection between the preoperative structural and functional status of the cervical spine and the postoperative 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. Preoperative and 3-month postoperative visual analogue scale (VAS) score, modified Japanese orthopaedic association (mJOA) score, and neck disability index (NDI) score were collected, and correlation analyses were performed with preoperative 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 preoperative cervical extension muscle strength was weakly positively correlated with the postoperative 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 postoperative VAS score (β=0.256, p=0.025) and NDI score (β=0.789, p=0.024). For the sum of posterior cervical muscles, preoperative fCSA of the right multifidus (MF) was weakly negatively correlated with the postoperative NDI score (r=-0.369, p=0.045). Conclusion: Our result suggested that stronger preoperative cervical extension strength may be important predictors of postoperative functional rehabilitation in patients after laminoplasty, especially in terms of axial symptoms.