Limitations of activities of daily living accompanying reduced neck mobility after cervical laminoplasty

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Abstract
After laminoplasty, difficulties with neck mobility often interfere with patients’ activities of daily living (ADL). Although it has been reported that the flexion–extension range of motion significantly decreased after laminoplasty, in many studies using radiographs there were few patient-based outcomes. The purpose of this study was to reveal the frequency, severity and factors related to limitations of ADL accompanying neck mobility after laminoplasty. A total of 58 patients were evaluated after laminoplasty to determine the frequency, severity and pre- and postoperative related factors of postoperative limitations of ADL accompanying each of three neck movements: (1) extension, (2) flexion and (3) rotation. The severity of limitations of each ADL was assessed using a questionnaire that was completed by the patient. Difficulties in neck movement, such as rotation (41%), extension (34%) and flexion (17%), in that order (P = 0.001), caused limitations of ADL. The most relevant factor of limitations of ADL accompanying extension, flexion, and rotation were small postoperative O–C7 range of motion (P = 0.0001), small preoperative O–C7 range of motion (P = 0.001), and small postoperative rotation range of motion (P = 0.0005), respectively. There were more than a few patients with limitations of ADL accompanying reduced neck mobility after laminoplasty. This knowledge may be useful in the clinical outcomes of cervical laminoplasty.

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