Cervical Radiculopathy: Incidence and Treatment of 1,420 Consecutive Cases.
METHODS
Retrospective case series.


OBJECTIVE
To determine the incidence of cervical radiculopathy requiring operative intervention by level and to report on the methods of treatment.


BACKGROUND
Cervical radiculopathy is a common cause of pain and can result in progressive neurological deficits. Although the pathology is well understood, the actual incidence of cervical radiculopathy at particular spinal levels ultimately requiring operative intervention is unknown.


METHODS
A large consecutive series of patients operated on by a single surgeon were retrospectively analyzed. The incidence of cervical radiculopathy at each level was defined for every patient. Procedures used for operative treatment were noted. Health related quality of life (HRQL) scores were collected both pre-operatively and postoperatively.


RESULTS
There were 1305 primary and 115 revision operations performed. The most common primary procedures performed were anterior cervical discectomy and fusion (ACDF, 50%) and anterior cervical corpectomy and fusion (ACCF, 28%). The most commonly affected levels were C6 (66%) and C7 (62%). Reasons for revision were pseudarthrosis (27%), clinical adjacent segment pathology (CASP, 63%), persistent radiculopathy (11%), and hardware-related (2.6%). The most common procedures performed in the revision group were posterior cervical decompression and fusion (PCDF, 42%) and ACDF (40%). The most commonly affected levels were C7 (43%) and C5 (30%). Among patients that had their index surgery at our institution, the revision rate was 6.4%. In both primary and revision cases there was a significant improvement in Neck Disability Index and visual analogue scale scores postoperatively. Postoperative HRQL scores in the revision cases were significantly worse than those in the primary cases (p <0.01).


CONCLUSIONS
This study provides the largest description of the incidence of cervical radiculopathy by level and operative outcomes in patients undergoing cervical decompression. The incidence of CASP was 4.2% in 3.3 years in this single institution series.
Spine Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA.
Han Jo
HJ
Kim
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Venu M
VM
Nemani
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Chaiwat
C
Piyaskulkaew
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Samuel Romero
SR
Vargas
Spine Division, Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA.
K Daniel
KD
Riew
Cervical; Cervical spondylosis; Cervicalgia; Radiculopathy; Spine osteoarthritis Copyright