Rare Intractable Cervicalgia Related to Exaggerated Disc Height Distraction : Report of Two Cases and Literature Review

Choi, Man Kyu; Kim, Sung Bum; Lee, June Ho

doi:10.3340/jkns.2017.0186

Cited by 6 publications

(12 citation statements)

References 19 publications

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“…This study also found that new-onset postoperative cervicalgia was higher at three and six months after ACDF compared with CDA and PCF. Choi et al 41 found similar results in their study. They found that disk heights postoperatively were significantly larger than preoperative disk heights.…”

Section: Discussionsupporting

confidence: 81%

Reoperation and Perioperative Complications after Surgical Treatment of Cervical Radiculopathy: A Comparison between Three Procedures

Nayak

Razzouk

Ramos

et al. 2022

Spine

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Study Design. A retrospective database study.Objective. The purpose of our study was to compare the perioperative complications and reoperation rates after anterior cervical discectomy and fusion (ACDF), cervical disk arthroplasty (CDA), and posterior cervical foraminotomy (PCF) in patients treated for cervical radiculopathy. Summary of Background Data. Cervical radiculopathy results from compression or irritation of nerve roots in the cervical spine. While most cervical radiculopathy is treated nonoperatively, ACDF, CDA, and PCF are the techniques most commonly used if operative intervention is indicated. There is limited research evaluating the perioperative complications of these surgical techniques. Materials and Methods. A retrospective review was performed using the PearlDiver Patient Record Database to identify cases of cervical radiculopathy that underwent ACDF, CDA, or PCF at one or two levels from 2007 to 2016. Perioperative complications and reoperations following each of the procedures were assessed. Results. During the study period, 25,051 patients underwent ACDF, 522 underwent CDA, and 3986 underwent PCF. After propensity score matching, each of the three groups consisted of 507 patients. Surgical site infection rates were highest after PCF (2.17%) compared with ACDF (0.20%) and CDA (0.59%) at 30 days and three months (P = 0.003, P < 0.001), respectively. New-onset cervicalgia was highest following ACDF (34.32%) and lowest after PCF (22.88%) at three and six months (P < 0.001 and P = 0.003), respectively. Revision surgeries were highest among those who underwent CDA (6.90%) versus ACDF (3.16%) and PCF (3.55%) at six months (P = 0.007). Limb paralysis was significantly higher after PCF compared with CDA and ACDF at six months (P < 0.017). Conclusions. The rate of surgical site infection was higher in PCF compared with ACDF and CDA. New-onset cervicalgia was higher after ACDF compared with PCF and CDA at short-term follow-up. Revision surgeries were highest among those undergoing CDA and lowest in those undergoing ACDF.

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Section: Discussionsupporting

confidence: 81%

Reoperation and Perioperative Complications after Surgical Treatment of Cervical Radiculopathy: A Comparison between Three Procedures

Nayak

Razzouk

Ramos

et al. 2022

Spine

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“…The postoperative disc heights were noticeably greater than the disc heights preoperatively due to over-sized implant insertion. 45 This finding emphasizes the importance of applying proper distraction forces and choosing a properly sized implant during ACDF surgery.…”

Section: Discussionmentioning

confidence: 90%

“… 41 - 43 Excessive distraction of the disc space during ACDF could result in stretching the posterior ligaments and facet joint injury, which may lead to subsequent postoperative neck pain. 44 Choi et al 45 reported postoperative intractable cervicalgia following ACDF. The postoperative disc heights were noticeably greater than the disc heights preoperatively due to over-sized implant insertion.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Mesregah

Formanek

Liu

et al. 2021

Global Spine Journal

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Study Design: Retrospective comparative study. Objectives: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty. Methods: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level. Results: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001. Conclusions: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion.

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“…8,9 The procedure itself, however, has the potential to increase facet mediated pain through overdistraction and abnormal tensile loading of the facet joint. [3][4][5][6]10 When performing an ACDF, intervertebral distraction is necessary to optimize visualization, facilitate graft insertion, and provide indirect nerve decompression. [11][12][13][14][15][16] Currently there is limited evidence defining the optimal intervertebral graft height to accomplish such goals.…”

Section: Introductionmentioning

confidence: 99%

Does Facet Distraction Affect Patient Outcomes After ACDF?

Karamian

Levy

Canseco

et al. 2021

Global Spine Journal

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Study Design: Retrospective cohort study Objective: The aim of this study is to determine if there is a correlation between the amount of facet distraction and postoperative patient-reported outcomes after ACDF. Methods: A retrospective cohort analysis of patients undergoing 1 to 3 level ACDF for degenerative pathologies at a single academic center was performed. Each patient received upright, lateral cervical spine x-rays at the immediate postoperative time point from which interfacet distance (facet distraction) was measured. Patient-reported outcome measures including NDI, PCS-12, MCS-12, VAS Neck, and VAS Arm pain scores were obtained preoperatively and at short-term (<3 months) and long-term (>1 year) follow-up. Receiver operating curves were generated to evaluate the possibility of a critical interfacet distraction distance. Univariate and multivariate analysis were performed to compare outcomes between groups based on the degree of facet distraction. Results: A total of 229 patients met the inclusion criteria. Receiver operating curves failed to yield a critical interfacet distraction distance associated with worse post-operative outcomes. Patients were instead grouped based on facet distraction distance below and above the third quartile (0.8mm-2.0 mm, 2.0mm-3.7 mm), with 173 and 56 patients in each respective group. Univariate analysis did not detect any statistically significant differences in outcome measures, recovery ratio, or % MCID achievement at short- and long-term follow-up between groups. Multivariate analysis also failed to demonstrate any significant differences between the facet distraction groups. Conclusion: Increased interfacet distance did not correlate with increased neck pain or disability after an ACDF.

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Rare Intractable Cervicalgia Related to Exaggerated Disc Height Distraction : Report of Two Cases and Literature Review

Cited by 6 publications

References 19 publications

Reoperation and Perioperative Complications after Surgical Treatment of Cervical Radiculopathy: A Comparison between Three Procedures

Reoperation and Perioperative Complications after Surgical Treatment of Cervical Radiculopathy: A Comparison between Three Procedures

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Does Facet Distraction Affect Patient Outcomes After ACDF?

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