Ending neck pain: the impact of anterior cervical discectomy and fusion in cervical radiculopathy.

BACKGROUND

Anterior cervical discectomy and fusion (ACDF) is a well-established surgical intervention for cervical radiculopathy, primarily indicated to relieve radicular symptoms. While some studies suggest that ACDF improves neck pain, historical data report inconsistent results. This study aimed to evaluate the impact of ACDF on neck pain in patients with isolated cervical radiculopathy treated at a high-volume tertiary care center.

METHODS

A retrospective review of all ACDF procedures performed at Leeds General Infirmary between January 2021 and March 2023 was conducted. Inclusion criteria were patients undergoing ACDF for isolated cervical radiculopathy. Exclusion criteria included procedures performed for other indications, including myelopathy, myeloradiculopathy, trauma, or tumors. VAS (Visual Analogue Scale) scores for neck pain were collected at four time points: preoperatively, 3 months, 6 months, and 12 months postoperatively. Statistical analysis included mean score comparisons and binomial distribution testing at a 1 % significance level. A total of 41 patients with complete data were included in the final analysis.

RESULTS

The mean preoperative VAS score was 8.32, indicating severe pain (VAS > 7.5). The reduction in neck pain following ACDF exceeded the minimum clinically important difference (MCID) of 2.6 at all postoperative time points, with mean improvements of 3.24 ± 1.76 (39.1 % pain reduction, t(40) = 11.8, p < 0.001), 3.61 ± 1.90 (43.4 % pain reduction, t(40) = 12.2, p < 0.001), and 3.83 ± 2.11 (46.0 % pain reduction, t(40) = 12.2, p < 0.001) at 3, 6, and 12 months, respectively. The proportion of patients reporting severe neck pain decreased significantly from 78.0 % preoperatively to 14.6 % postoperatively (p < 0.01).

CONCLUSIONS

ACDF significantly reduces neck pain in patients with cervical radiculopathy, with the most substantial improvement observed within the first three months postoperatively. Pain reduction remained stable and clinically meaningful for up to 12 months. These findings support the efficacy of ACDF in addressing radiculopathy and associated neck pain. Future prospective studies incorporating additional outcome measures, such as quality of life and mental health, are warranted to provide a more comprehensive assessment of patient benefits.