Tag Archive | cervical

May 2019 Article Exchange with JOSPT

In 2015, JBJS launched an “article exchange” collaboration with the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) to support multidisciplinary integration, continuity of care, and excellent patient outcomes in orthopaedics and sports medicine.

During the month of May 2019, JBJS and OrthoBuzz readers will have open access to the JOSPT article titled “Cervical Muscle Endurance Performance in Women With and Without Migraine.”

The authors of this cross-sectional laboratory study found that a group of 26 female patients with migraine exhibited a lower holding time for both neck-extensor and neck-flexor endurance than a group of 26 women without migraine. Both groups reported a similar level of neck pain, but only individuals in the migraine group reported pain referred to the head during testing.

Long-Term Revision Rates after Cervical Spine Arthrodesis

cervical-arthrodesisMost studies looking into revision rates after cervical spine fusion follow patients for 2 to 5 years. But in the September 21, 2016 issue of JBJS, Derman et al. investigate revision rates—and risk factors for revision—with a follow-up of 16 years.

Analyzing New York State’s SPARCS all-payer database, the authors identified more than 87,000 patients who underwent a primary subaxial cervical arthrodesis from 1997 through 2012. During the study period, 7.7% of the patients underwent revision, with a median time to revision of 24.5 months.

Cervical arthrodeses performed with anterior-only approaches had a significantly higher probability of revision than those performed via posterior or circumferential approaches. The authors also found that the following characteristics were associated with an elevated revision risk:

  • Patient age of 18 to 34 years
  • White race
  • Workers’ Compensation or Medicare (but not Medicaid) coverage
  • Arthrodeses to address spinal stenosis, spondylosis, deformity, or neoplasm

Shorter arthrodeses (i.e., fewer fusion levels) and arthrodesis to address fractures were associated with relatively lower revision risks.

The authors conclude that “knowledge of these factors should help to promote exploration of strategies to reduce the prevalence of revision(s)…and to facilitate more accurate preoperative counseling of patients.”