Fusion for occult posttraumatic cervical facet injury

Donlin M. Long, R. F. Davis, William G. Speed, Nelson H. Hendler

Research output: Contribution to journalArticle

Abstract

Persisting neck pain and headache is a common complication of acceleration/deceleration injury. Seventy patients with normal imaging studies and persisting pain after injury (median 1.7 y), who had failed all usual conservative forms of care were offered a diagnostic block protocol to determine the origins of the persisting pain. Blocks included C-2-3 roots bilaterally; C-2-3-4 zygapophyseal joints, and provocative discography at C-3-4, 4-5, 5-6, 6-7. Seventy patients entered the study; 67 completed the block protocol. On the basis of response to blocks, 44 patient were chosen for posterior cervical fusion of C-l, 2, 3, 4 in several combinations. Seventy-nine percent of patients achieved complete pain relief; 14% received satisfactory pain relief; fusion was achieved in 95%. These data support the hypothesis of Bogduk and associates that upper cervical facet injury is a common consequence of acceleration/ deceleration accidents. The symptoms can be relieved by upper cervical fusion in some patients selected by concordant blocks.

Original languageEnglish (US)
Pages (from-to)129-134
Number of pages6
JournalNeurosurgery Quarterly
Volume16
Issue number3
DOIs
StatePublished - Sep 1 2006

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Keywords

  • Facet injury
  • Fusion
  • Headache
  • Neck pain
  • Pain relief
  • Whiplash injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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