Background Osteoarthrosis 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. Objective To determine the success rates of arthrodesis of the lateral atlanto-axial joint for relieving neck pain and disability. Design Practice audit. Setting Private practice of senior author. Subjects Prospective series of 23 consecutive patients. Methods Outcomes 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. Results Complete 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. Conclusions The 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.

中文翻译：

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寰枢椎外侧关节融合术缓解颈部疼痛和颈源性头痛

背景 寰枢椎外侧关节 (LAAJ) 骨关节病可能是导致上颈部疼痛和头痛的原因。关节内注射类固醇只能提供短暂的缓解。对于顽固性疼痛，可以考虑关节融合术。目的 确定寰枢椎外侧关节融合术缓解颈部疼痛和残疾的成功率。设计实践审核。设置资深作者的私人执业。受试者 23 名连续患者的前瞻性系列。方法 使用颈部疼痛数字评定量表和颈部残疾指数来测量结果。计算长期随访（8-40 个月）中颈部疼痛不同程度改善的成功率，以及实现颈部疼痛和残疾改善的各种组合的成功率。结果 40% 的患者疼痛完全缓解，另外 40% 的患者疼痛缓解至少 50%。在长期随访中，30% 的患者没有颈部疼痛，也没有残疾，另外 25% 的患者只有轻微疼痛、轻微残疾或两者兼而有之。结论 本研究并未证实早期研究声称左膝关节融合术具有出色的疗效，但其结果与提供透明结果数据的最新研究一致。这些研究为疼痛医生提供了有关成功率和结果的经验数据，他们可以根据这些数据考虑转诊关节固定术。