• Richard D Ferch, Tyson Zhang, and Nikolai Bogduk.
• Department of Neurosurgery, John Hunter Hospital, Newcastle, NSW 2305, Australia.
• Pain Med. 2024 Mar 1; 25 (3): 203210203-210.

BackgroundOsteoarthrosis of the lateral atlanto-axial joint (LAAJ) may be a cause of upper neck pain and headache. Intra-articular injection of steroids may provide only short-lasting relief. For intractable pain, arthrodesis of the joint might be considered.ObjectiveTo determine the success rates of arthrodesis of the lateral atlanto-axial joint for relieving neck pain and disability.DesignPractice audit.SettingPrivate practice of senior author.SubjectsProspective series of 23 consecutive patients.MethodsOutcomes were measured using a numerical rating scale for neck pain, and the Neck Disability Index for disability. Success rates were calculated for various degrees of improvement of neck pain at long-term follow-up (8-40 months), and for achieving various combinations of improvement of both neck pain and disability.ResultsComplete relief of pain was achieved in 40% of patients, with a further 40% achieving at least 50% relief. At long-term follow-up, 30% of patients had no neck pain and no disability, and a further 25% had only minimal pain, minimal disability, or both.ConclusionsThe present study did not corroborate earlier studies that claimed outstanding outcomes for arthrodesis of the LAAJ, but its outcomes are consonant with more recent studies that provided transparent outcome data. These studies provide Pain Physicians with empirical data on success rates and outcomes, upon which they can base their consideration of referral for arthrodesis.© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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