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Is facet joint distraction associated with functional outcome in patients with cervical spondylotic radiculopathy treated with single-segment anterior cervical discectomy and fusion?

STUDY DESIGN A retrospective study. OBJECTIVE To explore (1) whether the degree of facet joint distraction during single-segment anterior cervical discectomy and fusion for cervical spondylotic radiculopathy affects functional outcome… Click to show full abstract

STUDY DESIGN A retrospective study. OBJECTIVE To explore (1) whether the degree of facet joint distraction during single-segment anterior cervical discectomy and fusion for cervical spondylotic radiculopathy affects functional outcome and (2) whether the degree of facet joint distraction is related to cervical sagittal parameters. METHODS This study retrospectively analyzed data from 72 patients with single-segment cervical spondylotic radiculopathy from January 2013 to December 2018. Lateral cervical radiographs were performed preoperatively and 12 months postoperatively. Disc height, interfacet distance and segmental angle were measured from the lateral cervical radiographs to evaluate facet joint distraction, and cervical sagittal parameters were measured. The outcome measures included VAS score and NDI score. RESULTS Sixty-eight patients were included.ΔInterfacet distance was statistically significant in relation to ΔVAS score (P < 0.01). ROC curve analysis: less than the mean ΔVAS score for all patients was set as a positive result, and the critical value of Δinterfacet distance was 0.7 mm (p=0.024, AUC=0.659, sensitivity =46.8%, specificity =78.8%). According to the critical value determined by the ROC curve, all patients were divided into the appropriate distraction group (AD group) or the excessive distraction group (ED group). There was a significant difference in VAS scores between the two groups (P < 0.05). CONCLUSION After undergoing single-segment ACDF for the treatment of cervical spondylotic radiculopathy, patients with an interfacet distance of 0.7 mm or more had worse VAS pain scores. However, this was not related to the improvement in postoperative NDI scores; changes in the interfacet distance were not associated with changes in the cervical sagittal parameters.

Keywords: cervical spondylotic; spondylotic radiculopathy; single segment; facet joint; joint distraction; distraction

Journal Title: World neurosurgery
Year Published: 2020

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