Interventional Management for Neck Pain Following Cervical Spinal Fusion: A Scoping Review.
7 affiliations
- 1Department of Biological Sciences, University of Toronto, Toronto, ON, Canada.
- 2Department of Surgery, Scarborough Health Network, Toronto, ON, Canada.
- 3Department of Neuroscience, University of Toronto, Toronto, ON, Canada.
- 4Department of Medicine, McMaster University, Hamilton, ON, Canada.
- 5Department of Surgery, Kaiser Oakland Medical Center, Oakland, CA, USA.
- 6Department of Physical Medicine and Rehabilitation, McMaster University, Hamilton, ON, Canada.
- 7Department of Surgery, University of Toronto, Toronto, ON, Canada.
Abstract
Purpose
A subset of patients develop chronic neck pain after cervical spinal fusion without identifiable or correctable surgical pathology. Interventional procedures have been proposed, but evidence specific to interventional management of neck pain following cervical fusion has not been comprehensively synthesized. This scoping review aimed to map the evidence on interventional procedures (Concept) for persistent neck pain in adults after cervical spinal fusion (Population) in clinical settings (Context) and identify gaps in the literature.Methods
A scoping review of MEDLINE, Embase, and CINAHL was conducted to March 2026 per PRISMA-ScR guidelines. The Population, Concept, and Context framework was used to determine inclusion criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, Newcastle-Ottawa Scale and Moga checklist. Findings were synthesized qualitatively and organized by intervention.Results
Thirteen studies met our inclusion criteria: 12 therapeutic studies (N = 532) across three intervention categories, and one prevalence study. Intervention categories included cervical epidural injection (CEI; one randomized controlled trial (RCT) with no placebo or sham, N = 116), facet-mediated interventions (FMIs; three studies, N = 219), and spinal cord stimulation (SCS; eight studies, N = 197). The CEI RCT reported 53-54% pain reduction, with responder rates at 69% and 71% at 24 months. FMIs showed 53% and 59% responder rates in two studies reporting outcomes in mixed populations. Reported SCS outcomes ranged from 25.7-82.5% across poorly controlled studies. Seven studies enrolled mixed cohorts with either confirmed post-fusion or cervical surgery patients, only providing indirect evidence. GRADE assessment was Moderate for CEI, Very Low for FMIs, and Very Low for SCS.Conclusion
The evidence was predominantly of very low certainty. An exploratory evidence-informed clinical framework was developed. A lack of evidence was identified for posterior cervical fusion patients and stratified outcome reporting for post-fusion subgroups.
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BibTeX
@article{kelil2026interventional,
title = {{Interventional Management for Neck Pain Following Cervical Spinal Fusion: A Scoping Review.}},
author = {Abdenour Kelil and Robert G Power and Austin Bermudez-Hiu and Manvir Matthew Bhangu and Robert Ravinsky and Ba Hoang Nguyen Pham and Zameer Pirani and Ahilraj Siva and Fan Jiang and Colby Oitment},
journal = {Journal of pain research},
year = {2026},
month = oct,
doi = {10.2147/jpr.s637812},
url = {https://europepmc.org/article/MED/42936217},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Interventional Management for Neck Pain Following Cervical Spinal Fusion: A Scoping Review.
AU - Abdenour Kelil
AU - Robert G Power
AU - Austin Bermudez-Hiu
AU - Manvir Matthew Bhangu
AU - Robert Ravinsky
AU - Ba Hoang Nguyen Pham
AU - Zameer Pirani
AU - Ahilraj Siva
AU - Fan Jiang
AU - Colby Oitment
PY - 2026
DA - 2026/10/22
JO - Journal of pain research
DO - 10.2147/jpr.s637812
UR - https://europepmc.org/article/MED/42936217
AB - Purpose A subset of patients develop chronic neck pain after cervical spinal fusion without identifiable or correctable surgical pathology. Interventional procedures have been proposed, but evidence specific to interventional management of neck pain following cervical fusion has not been comprehensively synthesized. This scoping review aimed to map the evidence on interventional procedures (Concept) for persistent neck pain in adults after cervical spinal fusion (Population) in clinical settings (Context) and identify gaps in the literature.Methods A scoping review of MEDLINE, Embase, and CINAHL was conducted to March 2026 per PRISMA-ScR guidelines. The Population, Concept, and Context framework was used to determine inclusion criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, Newcastle-Ottawa Scale and Moga checklist. Findings were synthesized qualitatively and organized by intervention.Results Thirteen studies met our inclusion criteria: 12 therapeutic studies (N = 532) across three intervention categories, and one prevalence study. Intervention categories included cervical epidural injection (CEI; one randomized controlled trial (RCT) with no placebo or sham, N = 116), facet-mediated interventions (FMIs; three studies, N = 219), and spinal cord stimulation (SCS; eight studies, N = 197). The CEI RCT reported 53-54% pain reduction, with responder rates at 69% and 71% at 24 months. FMIs showed 53% and 59% responder rates in two studies reporting outcomes in mixed populations. Reported SCS outcomes ranged from 25.7-82.5% across poorly controlled studies. Seven studies enrolled mixed cohorts with either confirmed post-fusion or cervical surgery patients, only providing indirect evidence. GRADE assessment was Moderate for CEI, Very Low for FMIs, and Very Low for SCS.Conclusion The evidence was predominantly of very low certainty. An exploratory evidence-informed clinical framework was developed. A lack of evidence was identified for posterior cervical fusion patients and stratified outcome reporting for post-fusion subgroups.
SN - 1178-7090
ER -