Vertebral distraction during anterior cervical discectomy and fusion causes postoperative neck pain

Seung Man Ha, Jeong Hoon Kim, Seung Hun Oh, Ji Hwan Song, Hyoung Ihl Kim, DongAh Shin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods: This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf·cm) and the low torque group (distraction force≤6 kgf·cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results: The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99×-1.1, r 2 =0.82; y=0.77×-0.63, r 2 =0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1±1.3, 2.6±1.0 compared with 6.0±0.6, 4.9±0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion: Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf·cm.

Original languageEnglish
Pages (from-to)288-292
Number of pages5
JournalJournal of Korean Neurosurgical Society
Volume53
Issue number5
DOIs
Publication statusPublished - 2013 Aug 7

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Diskectomy
Neck Pain
Torque
Postoperative Pain
Visual Analog Scale
Arm
Neck
Zygapophyseal Joint
Intervertebral Disc
Postoperative Period

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neuroscience(all)
  • Clinical Neurology

Cite this

Ha, Seung Man ; Kim, Jeong Hoon ; Oh, Seung Hun ; Song, Ji Hwan ; Kim, Hyoung Ihl ; Shin, DongAh. / Vertebral distraction during anterior cervical discectomy and fusion causes postoperative neck pain. In: Journal of Korean Neurosurgical Society. 2013 ; Vol. 53, No. 5. pp. 288-292.
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abstract = "Objective: Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods: This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf·cm) and the low torque group (distraction force≤6 kgf·cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results: The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99×-1.1, r 2 =0.82; y=0.77×-0.63, r 2 =0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1±1.3, 2.6±1.0 compared with 6.0±0.6, 4.9±0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion: Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf·cm.",
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Vertebral distraction during anterior cervical discectomy and fusion causes postoperative neck pain. / Ha, Seung Man; Kim, Jeong Hoon; Oh, Seung Hun; Song, Ji Hwan; Kim, Hyoung Ihl; Shin, DongAh.

In: Journal of Korean Neurosurgical Society, Vol. 53, No. 5, 07.08.2013, p. 288-292.

Research output: Contribution to journalArticle

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AU - Ha, Seung Man

AU - Kim, Jeong Hoon

AU - Oh, Seung Hun

AU - Song, Ji Hwan

AU - Kim, Hyoung Ihl

AU - Shin, DongAh

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N2 - Objective: Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods: This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf·cm) and the low torque group (distraction force≤6 kgf·cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results: The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99×-1.1, r 2 =0.82; y=0.77×-0.63, r 2 =0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1±1.3, 2.6±1.0 compared with 6.0±0.6, 4.9±0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion: Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf·cm.

AB - Objective: Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods: This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf·cm) and the low torque group (distraction force≤6 kgf·cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results: The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99×-1.1, r 2 =0.82; y=0.77×-0.63, r 2 =0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1±1.3, 2.6±1.0 compared with 6.0±0.6, 4.9±0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion: Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf·cm.

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