The effect of anterior cervical fusion on neck motion.
METHODS
Prospective cohort study.


OBJECTIVE
To precisely measure the effect of anterior cervical fusion on neck motion.


BACKGROUND
Anterior cervical decompression and stabilization procedures are successful in treating recalcitrant cervical radiculopathy and cervical myelopathy. Most assume that these "fusion" procedures result in a loss of neck motion, although changes in overall motion following anterior cervical fusion have never been precisely quantified.


METHODS
Twenty-five consecutive patients undergoing anterior cervical fusion of one to four levels underwent cervical range of motion testing in three planes using an unconstrained instrumented linkage before surgery and more than 3 months after surgery. These data were compared with that of 10 volunteers with no prior history of neck complaints. Motion data were compared between patients and volunteers, and between the patients before surgery and at last follow-up, using RMANOVA and Fisher's PLSD post hoc test.


RESULTS
Before surgery, the patients had significantly less motion than the volunteers in all directions. Following surgical fusion, patients gained a statistically significant amount of motion in all planes, although they did not achieve the motion seen among the volunteers. Gains in motion were seen among all patients, including those undergoing four-level fusions, and there was no correlation between postoperative motion and the number of levels fused.


CONCLUSIONS
Patients undergoing anterior cervical fusion have diminished neck motion compared with normal volunteers. Following surgery, they may be expected to gain motion, even when undergoing multilevel fusions. However, these patients are unlikely to regain the neck motion seen among normal individuals without neck complaints.
Hilibrand
Alan S
AS
Jefferson Medical College, Philadelphia, PA, USA. alan.hilibrand@mail.tju.edu
Balasubramanian
Karthik
K
Eichenbaum
Matthew
M
Thinnes
John H
JH
Daffner
Scott
S
Berta
Scott
S
Albert
Todd J
TJ
Vaccaro
Alexander R
AR
Siegler
Sorin
S
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009333:Neck / Q000502:physiology*; D019547:Neck Pain / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D011446:Prospective Studies; D011843:Radiculopathy / Q000503:physiopathology / Q000601:surgery; D016059:Range of Motion, Articular; D013117:Spinal Cord Compression / Q000503:physiopathology / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods