Correlation Between Facet Joint Distraction And Postoperative Neck Pain In Patients With Cervical Spondylotic Radiculopathy Treated With Single-segment Anterior Cervical Discectomy And Fusion

Background and ObjectiveAnterior cervical decompression and fusion(ACDF)has become the standard treatment for many patients with cervical spondylotic radiculopathy.The distraction of the vertebral body was helpful for the decompression of nerve root,but overdistraction may result in postoperative neck pain because of facet joint distraction or muscle spasm.There is no research report on the extent of distraction of ACDF intervertebral joint in cervical spondylotic radiculopathy.The purpose of this study was 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.MethodsThis 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.ResultsSixty-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 ofΔinterfacet 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 neck pain.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.