Fusion for occult posttraumatic cervical facet injury

Donlin M. Long, Randy 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 2006

Fingerprint

Wounds and Injuries
Pain
Deceleration
Zygapophyseal Joint
Neck Pain
Accidents
Headache

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Fusion for occult posttraumatic cervical facet injury. / Long, Donlin M.; Davis, Randy; Speed, William G.; Hendler, Nelson H.

In: Neurosurgery Quarterly, Vol. 16, No. 3, 09.2006, p. 129-134.

Research output: Contribution to journalArticle

Long, Donlin M. ; Davis, Randy ; Speed, William G. ; Hendler, Nelson H. / Fusion for occult posttraumatic cervical facet injury. In: Neurosurgery Quarterly. 2006 ; Vol. 16, No. 3. pp. 129-134.
@article{cb6e7253069d4e5196e99bcfc8dccc51,
title = "Fusion for occult posttraumatic cervical facet injury",
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.",
keywords = "Facet injury, Fusion, Headache, Neck pain, Pain relief, Whiplash injury",
author = "Long, {Donlin M.} and Randy Davis and Speed, {William G.} and Hendler, {Nelson H.}",
year = "2006",
month = "9",
doi = "10.1097/01.wnq.0000214023.47237.35",
language = "English (US)",
volume = "16",
pages = "129--134",
journal = "Neurosurgery Quarterly",
issn = "1050-6438",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Fusion for occult posttraumatic cervical facet injury

AU - Long, Donlin M.

AU - Davis, Randy

AU - Speed, William G.

AU - Hendler, Nelson H.

PY - 2006/9

Y1 - 2006/9

N2 - 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.

AB - 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.

KW - Facet injury

KW - Fusion

KW - Headache

KW - Neck pain

KW - Pain relief

KW - Whiplash injury

UR - http://www.scopus.com/inward/record.url?scp=33748468186&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748468186&partnerID=8YFLogxK

U2 - 10.1097/01.wnq.0000214023.47237.35

DO - 10.1097/01.wnq.0000214023.47237.35

M3 - Article

AN - SCOPUS:33748468186

VL - 16

SP - 129

EP - 134

JO - Neurosurgery Quarterly

JF - Neurosurgery Quarterly

SN - 1050-6438

IS - 3

ER -