Changes in Neck and Arm Pain after Anterior Cervical Decompression and Fusion

Abstract

This study aims to evaluate the trajectories of changes in arm and neck pain after anterior cervical discectomy and fusion (ACDF) due to degenerative cervical spine disease.

Pain severity was measured preoperatively and up to two years postoperatively among 248 consecutive patients undergoing ACDF due to radiating arm pain caused by degenerative cervical spine disease. The main statistical approach was MIXED modeling. Effects of some initial descriptive (grouping) variables on these changes were assessed by pairwise comparison of means.

Both neck and arm pain significantly reduced after surgery (p<0.001). Postoperatively, older patients demonstrated a greater reduction in neck pain of -4.7 (95% CI: -9.2 to -0.2) points. Substantial reduction in neck pain were observed in patients with severe preoperative neck and arm pain: -14.2 (95% CI: -19.7 to -8.7) and -12.0 (95% CI: -18.0 to -6.0) points, respectively

Both neck and arm pain diminished significantly after ACDF during two-year follow-up. This change was greater in those with severe preoperative arm or neck pain. Older patients more likely experienced a greater postoperative reduction in neck pain comparing to younger patients.