Authors: Peolsson, Anneli¹; Vavruch, Ludek²; Öberg, Birgitta¹

Source: Disability and Rehabilitation, Volume 28, Number 2, Number 2/January 2006 , pp. 117-124(8)

Publisher: Informa Healthcare

Abstract:

Purpose . There is no knowledge if short-term outcome in patients after anterior cervical decompression and fusion (ACDF) can be used to identify which patients have remaining deficit in long term. This study investigates if 6-month outcome with a broad assessment after ACDF with a cervical intervertebral fusion cage can be a guide for the 3-years outcome. Method . A prospective study. Questions about background data, pain, numbness, neck specific disability, distress, sick leave, health, symptom satisfaction and effect of and satisfaction with surgery were asked 28 patients 3 years after ACDF. Measurements have earlier been obtained before and 6 and 12 months after ACDF. Results . Compared with the results before surgery patients had improved in pain intensity ( p  = 0.001), neck pain (0.001), numbness ( p  = 0.02) and were more ‘satisfied' with having their neck problems ( p  = 0.01). Except for a worsening in expectations of surgery fulfilled ( p  = 0.04) there were no significant differences between 6-month and 3-year outcome. Three years after ACDF about two-thirds of the patients had remaining deficit with regard to pain intensity, Neck Disability Index, Distress and Risk Assessment Method and general health. According to the parameters studied 50 – 78% of those who at the 6-month follow-up were without deficit were still healthy at the 3-year follow-up. For patients with deficit at 6-month follow-up, still 83 – 100% had deficit 3 years after surgery. Conclusions . Despite a rather small study obtained the stability of 6-month and 3-year results indicates that short-term results might be sufficient for evaluating effects of the treatment. Since the patients in this study clearly demonstrate broad problems array of development of more structured multi-professional rehabilitation models including exercises which improve neck muscle strength, endurance and proprioception need to be introduced.

Keywords: Cervical radiculopathy; neck; surgery; cage; outcome

Document Type: Research article

DOI: http://dx.doi.org/10.1080/09638280500163752

Affiliations: 1: Department of Health and Society, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden 2: Department of Neuro-Orthopedic Surgery, Ryhov Hospital, Jönköping, Sweden

Publication date: 2006-01-01

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