Study Design, Data were collected prospectively on 38 patients who underwen
t anterior cervical discectomy and fusion for neck pain with no symptoms or
signs of radiculopathy or myelopathy.
Objectives, To determine the changes in pain and function after anterior ce
rvical discectomy and fusion for nonradicular neck pain.
Summary of Background Data. There is considerable controversy regarding the
role of anterior cervical discectomy and fusion for neck pain in the absen
ce of radiculopathy or myelopathy, Although no studies have addressed this
specific and common problem, it is known that anterior cervical discectomy
and fusion for radiculopathy or myelopathy may also provide relief of neck
pain for many patients.
Methods. Thirty-eight patients who underwent anterior cervical discectomy a
nd fusion for neck pain were evaluated. Before and after surgery, the autho
rs measured pain with a numerical rating scale, function with the Oswestry
Disability Questionnaire, and final patient satisfaction. Final evaluation
was done by a disinterested third party.
Results. All 38 patients were available for follow-up study. Mean age was 4
2.4 years, and mean duration of follow-up study was 53 months. All patients
had painful disc(s) proven by discography. No patients had nerve root comp
ression. Anterior cervical discectomy and fusion was performed at one level
in 21 patients, two levels in 16 patients, and three levels in one patient
. The mean score on the numerical rating scale for neck pain before surgery
was 8.3 (range, 3-10) versus 4.1 (range, 0-10) after surgery. This differe
nce is significant (P < 0.001). The mean score on the Oswestry Disability Q
uestionnaire was 57.5 (range, 0-89) before surgery versus 38.9 (range, 0-80
) after surgery. This difference is significant (P < 0.001). There were 30
(79%) patients who were satisfied with their outcome, and 8 (21%) who were
not satisfied. There was no statistical difference in change of pain or fun
ction between patients with worker's compensation and those with other insu
rance or between men and women. Twenty patients were not working because of
neck pain before surgery, and 15 were not working at the time of follow-up
examination.
Conclusion. A significant decrease in pain, a significant increase in funct
ion, and a high degree of patient satisfaction were found with anterior cer
vical discectomy and fusion for neck pain. Improvements were not affected b
y worker's compensation status or gender.