J Korean Neurosurg Soc.  2014 Jun;55(6):343-347. 10.3340/jkns.2014.55.6.343.

The Relationship between Increased Intervertebral Disc Height and Development of Postoperative Axial Neck Pain after Anterior Cervical Fusion

Affiliations
  • 1Department of Orthopedic Surgery, Busan Korea Hospital, Busan, Korea.
  • 2Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea. alla1013@naver.com

Abstract


OBJECTIVE
To evaluate the relationship between postoperative increase in intervertebral disc space height (IVH) and posterior axial neck in cases of degenerative cervical disease treated with anterior cervical discectomy and fusion (ACDF).
METHODS
A total of 155 patients who underwent ACDF with more than 1 year follow up were included. Radiologically, IVH and interfacet distance (IFD) of the operated segment were measured preoperatively and postoperatively. We clinically evaluated neck and arm pains according to visual analogue scale (VAS) scores and assessed neck disability index (NDI) scores preoperatively, postoperatively, at 3 months, 6 months, and 1 year postoperatively. The relationship between radiological parameters, and clinical scores were analyzed using a regression analysis.
RESULTS
The mean increase in IVH was 2.62 mm, and the mean increase in IFD was 0.67 mm. The VAS scores for neck pain preoperatively, postoperatively, and at 3 months, 6 months, 1 year postoperatively were 4.46, 2.11, 2.07, 1.95, and 1.29; those for arm pain were 5.89, 3.24, 3.20, 3.03, and 2.18. The NDI scores were improved from 18.52 to 7.47. No significant relationship was observed between the radiological evaluation results regarding the increase in intervertebral height or interfacet distance and clinical changes in VAS or NDI scores.
CONCLUSION
The increase in intervertebral space or interfacet distance by the insertion of a large graft material while performing ACDF for the treatment of degenerative cervical disease was not related with the change in VAS scores for neck and arm pains and NDI scores postoperatively and during the follow-up period.

Keyword

Cervical; ACDF; Neck pain; Intervertebral height; Graft size

MeSH Terms

Arm
Diskectomy
Follow-Up Studies
Humans
Intervertebral Disc*
Neck
Neck Pain*
Transplants

Figure

  • Fig. 1 A : Measurement of intervertebral distance. Length between the center of the superior end plate of upper vertebral body and the inferior end plate of lower vertebral body was measured. B : Measurement of interfacet distance. Longest distance was measured between the facet joint of operated segment.


Cited by  1 articles

Rare Intractable Cervicalgia Related to Exaggerated Disc Height Distraction : Report of Two Cases and Literature Review
Man Kyu Choi, Sung Bum Kim, Jun Ho Lee
J Korean Neurosurg Soc. 2018;61(4):530-536.    doi: 10.3340/jkns.2017.0186.


Reference

1. Albert TJ, Smith MD, Bressler E, Johnson LJ. An in vivo analysis of the dimensional changes of the neuroforamen after anterior cervical diskectomy and fusion : a radiologic investigation. J Spinal Disord. 1997; 10:229–233. PMID: 9213279.
2. An HS, Evanich CJ, Nowicki BH, Haughton VM. Ideal thickness of Smith-Robinson graft for anterior cervical fusion. A cadaveric study with computed tomographic correlation. Spine (Phila Pa 1976). 1993; 18:2043–2047. PMID: 8272957.
3. Bayley JC, Yoo JU, Kruger DM, Schlegel J. The role of distraction in improving the space available for the cord in cervical spondylosis. Spine (Phila Pa 1976). 1995; 20:771–775. PMID: 7701388.
Article
4. Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery : a prospective study. Spine (Phila Pa 1976). 2002; 27:2453–2458. PMID: 12435974.
5. Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2003; 14:455–472. vPMID: 12948338.
Article
6. Bohlman HH, Emery SE, Goodfellow DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am. 1993; 75:1298–1307. PMID: 8408151.
Article
7. Brigham CD, Tsahakis PJ. Anterior cervical foraminotomy and fusion. Surgical technique and results. Spine (Phila Pa 1976). 1995; 20:766–770. PMID: 7701387.
Article
8. Cavanaugh JM, Lu Y, Chen C, Kallakuri S. Pain generation in lumbar and cervical facet joints. J Bone Joint Surg Am. 2006; 88(Suppl 2):63–67. PMID: 16595446.
Article
9. Cavanaugh JM, Ozaktay AC, Yamashita HT, King AI. Lumbar facet pain : biomechanics, neuroanatomy and neurophysiology. J Biomech. 1996; 29:1117–1129. PMID: 8872268.
10. Emery SE, Bolesta MJ, Banks MA, Jones PK. Robinson anterior cervical fusion comparison of the standard and modified techniques. Spine (Phila Pa 1976). 1994; 19:660–663. PMID: 8009330.
11. Igarashi A, Kikuchi S, Konno S, Olmarker K. Inflammatory cytokines released from the facet joint tissue in degenerative lumbar spinal disorders. Spine (Phila Pa 1976). 2004; 29:2091–2095. PMID: 15454697.
Article
12. Jho HD. Microsurgical anterior cervical foraminotomy for radiculopathy : a new approach to cervical disc herniation. J Neurosurg. 1996; 84:155–160. PMID: 8592215.
Article
13. Matsumoto M, Okada E, Ichihara D, Watanabe K, Chiba K, Toyama Y, et al. Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion : 10-year follow-up study using MRI. Eur Spine J. 2012; 21:304–308. PMID: 21858566.
Article
14. Pickett GE, Sekhon LH, Sears WR, Duggal N. Complications with cervical arthroplasty. J Neurosurg Spine. 2006; 4:98–105. PMID: 16506475.
Article
15. Ponnappan RK, Nassr A, Kang JD. Anterior decompression, instrumentation, fusion techniques : discectomy, foraminotomy, disc space carpentry. In : Bridwell KH, Dewald RL, editors. The Textbook of Spinal Surgery. ed 3. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins;2011. p. 258–260.
16. Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for the cervical disc syndrome. Bull John Hopkins Hosp. 1955; 96:223–224.
17. Ryu KS, Park CK, Jun SC, Huh HY. Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up : comparison between the Bryan and Prodisc-C devices. J Neurosurg Spine. 2010; 13:299–307. PMID: 20809721.
Article
18. Seo JY, Ha KY. Fate of posterior osteophytes in fused segments after anterior cervical discectomy and fusion. Spine (Phila Pa 1976). 2012; 37:741–747. PMID: 21912323.
Article
19. Shen FH, Samartzis D, Khanna N, Goldberg EJ, An HS. Comparison of clinical and radiographic outcome in instrumented anterior cervical discectomy and fusion with or without direct uncovertebral joint decompression. Spine J. 2004; 4:629–635. PMID: 15541694.
Article
20. Ylinen JJ, Savolainen S, Airaksinen O, Kautiainen H, Salo P, Häkkinen A. Decreased strength and mobility in patients after anterior cervical diskectomy compared with healthy subjects. Arch Phys Med Rehabil. 2003; 84:1043–1047. PMID: 12881832.
Article
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