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  • Neck Pain: Is Fusion the Solution? A Meta-analysis of 2187 Patients

    Final Number:
    313

    Authors:
    Mohammed Aref MD; Ahmed Aljishi; Tracy Watson; Edward Kachur MD; Forrough Farrokhyar; Aleksa A. Cenic MD, MSc, BSc

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: The prevalence of neck pain is estimated to be between 22-70%, it is among the highest in workers' compensation and causes 5% of the population to be disabled. The pathophysiology of neck is poorly understood, which led to a multitude of treatments being proposed to treat neck pain. Surgical intervention in the form fusion is currently not a standard treatment for isolated neck pain. However, patients do report change in the quality of neck pain following ACDF surgery. Our objective is to correlate the degree of neck pain relief with ACDF surgery.

    Methods: A systematic review was done by a certified librarian. Following which two reviewers (MA, AA), reviewed all the studies independently and included all studies correlating single level ACDF with neck pain using the visual analogue scale (VAS), or neck disability index (NDI) scale. The two reviewer correlated their findings, and disagreements were resolved by the senior author.

    Results: A total of 32 studies were included in the final analysis, with a total number of patients of 2187. The mean age was 45, and pre-operative NDI was 52.68, and pre-operative VAS was 6.8. Immediate post-op NDI was 29.9, and 6.0 for VAS. At 6 month NDI was 22.41, and VAS was 2.51,, at 112 months NDI was 22.18, and VAS was 2.63. At 24 months NDI was 22.25 and VAS 2.7.

    Conclusions: Results show a statistically significant decrease in neck indices following ACDF surgery. The results suggest that there is probably a positive correlation between ACDF surgery and neck pain.

    Patient Care: Introducing new measures and changing the indications to perform ACDF. Introducing ACDF as potential treatment in cases of intractable neck pain.

    Learning Objectives: Exploring the surgical role in the treatment of neck pain, and the possibility of reducing the pain by stabilizing the cervical spine.

    References:

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