Way Yin1, Nikolai Bogduk. 1. Interventional Medical Associates of Bellingham, Bellingham, Washington, USA.
Abstract
OBJECTIVE: To determine the prevalence of different causes of neck pain in a private practice clinic. DESIGN: A retrospective audit of records. SETTING: A private spine pain clinic in the state of Washington, USA. PATIENTS: All consecutive patients, seen between January 2003 and January 2005, in whom a diagnosis of neck pain was made. Interventions. The records of all patients were examined to determine the prevalence of various diagnostic entities determined by history, examination, and invasive test such as controlled diagnostic blocks and provocation discography. OUTCOME MEASURES: Using different denominators, the prevalence of various conditions was determined in all patients who presented with neck pain, in patients in whom investigations were undertaken, and in patients who completed investigations. RESULTS: A large proportion of patients (36%) did not pursue investigations, which diluted the crude prevalence of various conditions. A further 17% deferred completing investigations. Among the 46% of patients who completed investigations, the prevalence of zygapophysial joint pain was 55%, discogenic pain was 16%, and lateral atlanto-axial joint pain was 9%. A diagnosis remained elusive in only 32% of those patients who completed investigations. CONCLUSIONS: In a private practice setting, a patho-anatomic diagnosis for chronic neck pain can be established in over 80% of patients, provided that appropriate investigations are undertaken. The prevalence of cervical zygapophysial joint pain encountered in the present study corroborates the prevalence rates established in academic studies. Cervical discogenic pain does not appear to be common among patients with chronic neck pain.
OBJECTIVE: To determine the prevalence of different causes of neck pain in a private practice clinic. DESIGN: A retrospective audit of records. SETTING: A private spine pain clinic in the state of Washington, USA. PATIENTS: All consecutive patients, seen between January 2003 and January 2005, in whom a diagnosis of neck pain was made. Interventions. The records of all patients were examined to determine the prevalence of various diagnostic entities determined by history, examination, and invasive test such as controlled diagnostic blocks and provocation discography. OUTCOME MEASURES: Using different denominators, the prevalence of various conditions was determined in all patients who presented with neck pain, in patients in whom investigations were undertaken, and in patients who completed investigations. RESULTS: A large proportion of patients (36%) did not pursue investigations, which diluted the crude prevalence of various conditions. A further 17% deferred completing investigations. Among the 46% of patients who completed investigations, the prevalence of zygapophysial joint pain was 55%, discogenic pain was 16%, and lateral atlanto-axial joint pain was 9%. A diagnosis remained elusive in only 32% of those patients who completed investigations. CONCLUSIONS: In a private practice setting, a patho-anatomic diagnosis for chronic neck pain can be established in over 80% of patients, provided that appropriate investigations are undertaken. The prevalence of cervical zygapophysial joint pain encountered in the present study corroborates the prevalence rates established in academic studies. Cervical discogenic pain does not appear to be common among patients with chronic neck pain.
Authors: S Finkenstaedt; A F Mannion; T F Fekete; D Haschtmann; F S Kleinstueck; U Mutter; H J Becker; D Bellut; F Porchet Journal: Eur Spine J Date: 2019-07-08 Impact factor: 3.134
Authors: Robert W Hurley; Meredith C B Adams; Meredith Barad; Arun Bhaskar; Anuj Bhatia; Andrea Chadwick; Timothy R Deer; Jennifer Hah; W Michael Hooten; Narayan R Kissoon; David Wonhee Lee; Zachary Mccormick; Jee Youn Moon; Samer Narouze; David A Provenzano; Byron J Schneider; Maarten van Eerd; Jan Van Zundert; Mark S Wallace; Sara M Wilson; Zirong Zhao; Steven P Cohen Journal: Pain Med Date: 2021-11-26 Impact factor: 3.750
Authors: Robert W Hurley; Meredith C B Adams; Meredith Barad; Arun Bhaskar; Anuj Bhatia; Andrea Chadwick; Timothy R Deer; Jennifer Hah; W Michael Hooten; Narayan R Kissoon; David Wonhee Lee; Zachary Mccormick; Jee Youn Moon; Samer Narouze; David A Provenzano; Byron J Schneider; Maarten van Eerd; Jan Van Zundert; Mark S Wallace; Sara M Wilson; Zirong Zhao; Steven P Cohen Journal: Reg Anesth Pain Med Date: 2021-11-11 Impact factor: 6.288
Authors: Peter G Passias; Saqib Hasan; Kris Radcliff; Robert Isaacs; Kristina Bianco; Cyrus M Jalai; Gregory W Poorman; Nancy J Worley; Samantha R Horn; Anthony Boniello; Peter L Zhou; Paul M Arnold; Patrick Hsieh; Alexander R Vaccaro; Michael C Gerling Journal: Int J Spine Surg Date: 2018-10-15