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. 2022 Aug 3;23(1):741.
doi: 10.1186/s12891-022-05705-y.

Effect of facet joint distraction on the functional and radiological outcomes after anterior cervical disc replacement

Chunyi Yan #  1 , Hong Wang #  1 , Tingkui Wu  1 , Chengyi Huang  1 , Haimiti Abuduaini  1 , Beiyu Wang  1 , Hao Liu  2
Affiliations

Effect of facet joint distraction on the functional and radiological outcomes after anterior cervical disc replacement

Chunyi Yan et al. BMC Musculoskelet Disord. .

Abstract

Objective: The purpose of this study is to explore: 1) whether the extent of facet joint distraction affects functional outcomes following single-level anterior cervical disc replacement (ACDR) for cervical spondylotic radiculopathy and 2) whether the extent of facet joint distraction correlates with the cervical sagittal parameters.

Methods: We performed a retrospective analysis on 70 patients who had undergone a single-level ACDR to treat cervical spondylotic radiculopathy between January 2014 and December 2018. Pre- and post-operative lateral cervical spine X-ray radiographs were collected to determine radiographic parameters, including C0-C2 angle, C2-C7 angle, C7 Slope (C7S), T1 Slope (T1S), C2-C7 sagittal vertical axis (SVA), C2-C7 range of motion (ROM), Segmental ROM, disc height (DH) and inter-facet distance (ID). And the extend of facet joint distraction was evaluated by the two indexes: degree of intervertebral distraction (DID) defined and degree of facet joint distraction (DFJD). The visual analog scale (VASneck) and the Neck Disability Index scores (NDI) were adopted to demonstrate functional outcomes. Patients with the functional outcome improvement below the average were set as the positive group in the receiver operating characteristic (ROC) curve analysis, to find an optimal cut-off value of extent of facet joint distraction.

Results: VASneck and NDI scores improved significantly from pre- to post-operation among the entire cohort, and DFJD had a statistically significant negative correlation with ΔVASneck (p < 0.001) and ΔNDI (p < 0.001). According to ROC curve analysis, the cut-off value of DFJD for differing the appropriate and excessive distraction groups was set at 29.16% (sensitivity = 70.73%, specificity = 67.86%). Between these two groups, the ΔT1S, ΔROM, ΔVASneck, and ΔNDI were significantly different (p < 0.05).

Conclusion: Single-segment ACDR may improve the functional outcome of patients with cervical spondylotic radiculopathy. However, those whose DFJD was greater than 29.16% had worse VASneck and NDI scores, as well as a lower ΔT1S and a lower ΔROM.

Keywords: Cervical disc replacement; Cervical spondylotic radiculopathy; Facet joint distraction; Functional outcome; Radiological outcome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The measuring methods of imaging parameters
Fig. 2
Fig. 2
Receiver operating characteristic curve of VAS
Fig. 3
Fig. 3
Receiver operating characteristic curve of NDI
See this image and copyright information in PMC

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