Neck motion following multilevel anterior cervical fusion: comparison of short-term and midterm results

Clinical article

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Object

Multilevel anterior cervical decompression and fusion is indicated for patients with multilevel compression or stenosis of the spinal cord. Some have reported that this procedure would lead to a loss of cervical range of motion (CROM). However, few studies have demonstrated the exact impact of the procedure on CROM. Here, the authors describe short- and midterm postoperative CROM following multilevel anterior cervical decompression and fusion.

Methods

Thirty-five patients underwent a 3- or 4-level anterior cervical decompression and fusion. In all patients, active CROM was measured preoperatively and at both the short-term (3–4 months) and midterm (12–15 months) follow-ups by using a CROM device. The preoperative and postoperative data were analyzed using ANOVA (α = 0.05).

Results

Patients had significantly less ROM in all planes of motion postoperatively. The greater limitation in CROM was observed at the short-term follow-up. However, at the midterm follow-up, an obvious increase in CROM was observed in each cardinal plane compared with that in the short-term (sagittal plane 17.4%, coronal plane 14.1%, and horizontal plane 19.5%). A gradual increase in the CROM in each cardinal plane was observed during the recovery period in 5 patients. In the 6 conventional motions, the major recovery of CROM was observed in flexion (27.5%), while relatively less recovery was seen in extension (10.5%).

Conclusions

Patients had an obvious reduction in active CROM following multilevel anterior cervical decompression and fusion. The greater limitation in CROM was observed at the short-term follow-up. In the midterm follow-up, however, an obvious recovery in CROM was observed in each cardinal plane, reducing the restriction of neck motion further.

Abbreviations used in this paper:CROM = cervical range of motion; NDI = Neck Disability Index.
Article Information

Contributor Notes

* Drs. Wu, Hua-Jiang Chen, and Yu Chen have contributed equally to this work.Address correspondence to: Wen Yuan, M.D., Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Fengyang Road, Shanghai 200003, China. email: acorepie@126.com.Please include this information when citing this paper: published online February 1, 2013; DOI: 10.3171/2013.1.SPINE12638.
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