The prevalence cervical facet arthrosis: an osseous study in a cadveric population

Abstract

Background context Cervical facet arthrosis has been implicated as a cause for neck pain, radiculopathy, occipital headache, and ear pain. Purpose The objective of this study was to examine the occurrence of facet arthrosis in the cervical spine. Study design/setting This study examined cadaveric specimens from the Hamann Todd Collection. Patient sample None. Outcomes measures None. Materials and methods Four hundred sixty-five skeletally mature human cervical spines from the Hamann Todd Collection in the Cleveland Museum of Natural History were obtained for analysis. We analyzed the facets for arthrosis. We graded no arthrosis as Grade 0. Facets with peripheral osteophytic reaction, but with no lateral mass distortion were graded as Grade 1. Facets with peripheral osteophytic reaction and lateral mass distortion were graded as Grade 2. Facets that were ankylosed were graded as Grade 3. Each specimen was examined bilaterally at levels from C2–C3 through C6–C7, yielding 4,650 specimen assessments. The data were analyzed to compare cervical levels, gender, facet side, age groups, and race. Proportion analysis, using the Fisher exact test, was used to assess for statistical difference between various groupings. Results In the entire population of 465 specimens, the upper cervical specimens appeared to be affected by facet arthrosis more frequently than the lower levels; 12.37% of the specimens had bony evidence of arthrosis at the C2–C3 level; 13.33% of the specimens had arthrosis occur at the C3–C4 level; 14.62% at the C4–C5 level; 7.85% at the C5–C6 level, and 4.84% at the C6–C7 level. The large majority of all cervical facet arthrosis was found to be Grade 1 at all levels. In the older population, the prevalence of facet arthrosis is as high as 29.87% for the C4–C5 level. C4–C5 level appears to be affected the most frequently, followed by the C3–C4 level, then C2–C3, C5–C6, and C6–C7. Conclusion The prevalence of cervical facet arthrosis increases with age, and occurs more commonly in the upper cervical spine.