Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Rare Intractable Cervicalgia Related to Exaggerated Disc Height Distraction : Report of Two Cases and Literature Review

  • Choi, Man Kyu (Department of Neurosurgery, Daegu Catholic University Medical Center, College of Medicine, Catholic University of Daegu) ;
  • Kim, Sung Bum (Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine) ;
  • Lee, Jun Ho (Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine)
  • Received : 2017.06.12
  • Accepted : 2017.08.31
  • Published : 2018.07.01
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Abstract

We present two cases of unexpected postoperative intractable cervicalgia due to over-sized implant insertion during simple anterior cervical decompression and fusion (ACDF) or artificial disc replacement (ADR). These patients experienced severe cervicalgia mostly related to their neck motion even after standard cervical operations. In both cases, the restored disc heights after the operations were prominently greater than the preoperative disc heights. The patients had not responded to any of the conservative treatments, and unloading of these excessively distracted segments through ultimate revision surgery led to dramatic pain relief. This report emphasizes the increase in distractional forces that takes place after a standard ACDF or ADR, as well as the importance of a proper sized implant. It also includes the reviews of other biomechanical or clinical reports dealing with this issue, thereby cautioning the surgeons not to disregard these factors, which might have an adverse effect in patients with cervicalgia even after radiographically successful cervical procedures.

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References

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