Artikel
Comparison of the prevalence of cervical facet joint-related pain between artificial disc operations and anterior cervical fusion
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Autoren
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S. Klessinger
- Neurochirurgie, nova clinic Biberach
| Veröffentlicht: | 20. Mai 2009 |
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Gliederung
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Objective: Cervical zygapophyseal joints are clinically important pain generators in a significant number of patients with chronic persistent neck pain after anterior cervical spine surgery. The present retrospective study was designed to compare the prevalence of cervical facet joint pain associated with artificial disk implantation versus arthrodesis with cage or cage and plate.
Methods: During a 2 years period all consecutive patients who underwent a ventral cervical operation were included. Controlled cervical medial branch blocks were used to evaluate patients with neck pain after the operation. A single physician performed the operations. The medial branch blocks were done in an interventional pain management ambulatory surgery centre according to the guidelines of the International Spine Intervention Society (ISIS). The prevalence of facet joint syndrome was assessed in relation to age, gender, single or double level operation and artificial disc versus stand alone cage and cage with plate.
Results: A total of 166 operations were performed, 102 of them artificial disc operations (87 Prodisc C, 15 Prestige), 32 stand-alone cages (15 titan, 17 PEEK) and 32 fusions with cage and plate. In 42 patients a double level operation was performed. The average follow-up time was 6 month. Only one patient was lost in follow up. The prevalence of cervical facet joint pain (positive tested with medial branch block) was 28,5 % (47 patients). Comparing artificial disc operations versus fusion with plate a statistically significant difference was found (artificial disc: 32,3 % prevalence, fusion with plate: 12,5 % prevalence, p = 0,03). There was no difference in age, gender, double or single level and comparison of artificial disc versus stand alone cage.
Conclusions: Zygapophyseal joints are a viable source of postoperative pain after anterior cervical spine surgery. The prevalence is independent of age, gender or the level of operation. There is a statistically significant difference between artificial disc and fusion with cage and plate.
