Study Design: A cadaver and clinical study investigated the attachment of the nuchal ligament to the cervical spinous process.
Objective: To investigate the anatomical details of the attachment of the nuchal ligament to the spinous process and the relationship between the morphology of the nuchal ligament and postoperative axial pain after laminoplasty.
Summary Of Background Data: The relationship between the length of the C6 spinous process and the morphology of the nuchal ligament and occurrence of postoperative axial pain has not been elucidated.
Methods: The morphology of the nuchal ligament was investigated in 35 cadavers and 60 patients on preoperative computed tomography and magnetic resonance imaging. The lengths of the C6 and C7 spinous processes were measured, and the C6:C7 ratio (C6 spinous process length/C7 spinous process length) was calculated. The relationship between the morphology of the attachment of nuchal ligament to the C6 spinous process and the C6:C7 ratio were investigated. In addition, the effects of the anatomy of the nuchal ligament around the C6 spinous process and different procedures of surgical invasion to C6 or C7 on postoperative axial pain were investigated for 113 patients who underwent laminoplasty.
Results: The nuchal ligament was attached to not only the C7 spinous process, but also the C6 spinous process when the C6:C7 ratio was more than 0.8. When the nuchal ligament was attached to the C6 spinous process and to C7, postoperative axial pain after C3-C7 laminoplasty occurred more often compared with C3-C6 laminoplasty for patients without the nuchal ligament attached to the C6 spinous process.
Conclusion: This study shows that there is an association between the individual anatomical differences of the nuchal ligament and the occurrence of postoperative axial pain after laminoplasty. Careful attention should be paid to the morphology of the attachment of the nuchal ligament to the C6 spinous process to reduce postoperative axial pain.
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http://dx.doi.org/10.1097/BRS.0b013e318274101b | DOI Listing |
Sci Rep
November 2024
School of Medicine, I-Shou University, Kaohsiung, Taiwan.
Neck pain due to cervical facet joint pain has a prevalence of 36-60% in chronic neck pain. Pulsed radiofrequency for such pain has been verified. After proper patient selection, pulsed radiofrequency of the cervical facet joints provide long-term pain relief in a routine clinical setting.
View Article and Find Full Text PDFJ Orthop Sci
November 2024
Exercise Science Research Center, University of Arkansas, Fayetteville, AR, USA. Electronic address:
Background: 40-45 % of the population presents with enlarged external occipital protuberances (EEOPs), which can lead to pain. EEOP occurrence is higher in younger males; however, the reason is debated. We used plane lateral radiographs to investigate how anthropometrics, age, biological sex, head and neck kinematics, and neck strength differ between those with and without an EEOP.
View Article and Find Full Text PDFJBJS Case Connect
October 2024
Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.
Case: An 86-year-old woman suffered from dropped head syndrome (DHS). As she was not willing to undergo fusion surgery, we proposed a novel nuchal ligament reconstruction surgery, which is not a direct correction of the malalignment but rather a recovery of the function of extensor muscles under local anesthesia. Twelve months after surgery, the patient remains satisfied and is able to maintain a horizontal gaze.
View Article and Find Full Text PDFMed Sci Monit
August 2024
Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
BACKGROUND Long-term clinical practice has suggested a possible association between ossification of cervical ligament (OCL) and primary osteoporosis (POP). However, there is a lack of relevant research data. This study aimed to clarify the potential relationship between OCL and POP, and propose new strategies for preventing the onset of POP.
View Article and Find Full Text PDFBMJ Case Rep
July 2024
Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
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