Anterior cervical decompression and fusion on neck range of motion, pain, and function: a prospective analysis

作者：Landers Merrill R^*; Addis Kate A; Longhurst Jason K; vom Steeg Bree lyn; Puentedura Emilio J; Daubs Michael D

来源：Spine Journal, 2013, 13(11): 1650-1658.

DOI：10.1016/j.spinee.2013.06.020

• Cervical
• Range of motion
• Radiculopathy
• Outcomes

BACKGROUND CONTEXT: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion (ACDF) procedure. However, there is little evidence in the literature that demonstrates the impact such surgery has on long-term range of motion (ROM) outcomes.
PURPOSE: The objective of this study was to compare cervical ROM and patient-reported outcomes in patients before and after a 1, 2, or 3 level ACDF.
STUDY DESIGN: Prospective, nonexperimental.
PATIENT SAMPLE: Forty-six patients.
OUTCOME MEASURES: The following were measured preoperatively and also at 3 and 6 months after ACDF: active ROM (full and painfree) in three planes (ie, sagittal, coronal, and horizontal), pain visual analog scale, Neck Disability Index, and headache frequency.
METHODS: Patients undergoing an ACDF for cervical radiculopathy had their cervical ROM measured preoperatively and also at 3 and 6 months after the procedure. Neck Disability Index and pain visual analog scale values were also recorded at the same time.
RESULTS: Both painfree and full active ROM did not change significantly from the preoperative measurement to the 3-month postoperative measurement (ps>.05); however, painfree and full active ROM did increase significantly in all three planes of motion from the preoperative measurement to the 6-month postoperative measurement regardless of the number of levels fused (ps <=.023). Visual analog scale, Neck Disability Index, and headache frequency all improved significantly over time (ps <=.017).
CONCLUSIONS: Our results suggest that patients who have had an ACDF for cervical radiculopathy will experience improved ROM 6 months postoperatively. In addition, patients can expect a decrease in pain, an improvement in neck function, and a decrease in headache frequency.

• 出版日期2013-11