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World Neurosurg. 2017 Apr;100:7-14. doi: 10.1016/j.wneu.2016.12.125. Epub 2017 Jan 5.

Posterior Cervical Transfacet Fusion with Facetal Spacer for the Treatment of Single-Level Cervical Radiculopathy: A Randomized, Controlled Prospective Study.

Author information

1
Neurological Center of Latium, Neurosurgery, Rome, Italy.
2
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
3
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy. Electronic address: capor51@gmail.com.

Abstract

BACKGROUND:

Single-level cervical radiculopathy may be treated conservatively with cervical tractions. Posterior cervical transfacet fusion with a facetal spacer is a viable option. The aim of the present study is to compare posterior cervical transfacet fusion with conservative physical treatment in single-level cervical radiculopathy.

METHODS:

A total of 80 patients were randomized in 2 groups, a surgical group in which patients were given posterior cervical transfacet fusion and a traction group in which patients were treated conservatively with mechanical cervical tractions. Visual analog scale for arm and neck, Neck Disability Index, and Short Form-36 (SF-36) questionnaires were administered preoperatively and after treatment up to 12 months.

RESULTS:

After treatment, visual analog scale arm scores were greater in traction group (4.7 vs. 1.5 the day after treatment) and at follow-up controls (traction group vs. surgical group: 5.3 vs. 0.6 at 1 month, 3.6 vs. 0.3 at 6 months, 1.8 vs. 0.2 at 12 months). Neck Disability Index scores were lower in the surgical group (surgical group vs. traction group: 4.4 vs. 20.3 at 1 month, 1.3 vs. 10.5 at 6 months). SF-36 scores were greater in the surgical group (surgical group vs. traction group: 96 vs. 70 at 1 month, 96.5 vs. 82.6 at 6 months). Neck disability index and SF-36 scores were superimposable between the groups at 12-month follow-up. No adjacent-segment arthrosis or late complications were reported at 1-year follow-up in the surgical group.

CONCLUSIONS:

posterior cervical transfacet fusion is a safe and effective procedure to treat single-level cervical radiculopathy.

KEYWORDS:

Cervical disc herniation; Cervical manipulation; Cervical radiculopathy; Cervical stenosis; Cervical transfacet fusion; Mechanical cervical traction; Minimally invasive surgery; Percutaneous cervical fusion; Posterior cervical fusion; Randomized controlled study

PMID:
28065872
DOI:
10.1016/j.wneu.2016.12.125
[Indexed for MEDLINE]

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