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

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

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Conservative Treatment
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Neck Pain / etiology
  • Neck Pain / therapy
  • Pain Measurement
  • Radiculopathy / complications
  • Radiculopathy / diagnostic imaging
  • Radiculopathy / surgery*
  • Radiculopathy / therapy
  • Spinal Fusion / methods*
  • Surveys and Questionnaires
  • Traction
  • Treatment Outcome