title: The effect of multilevel anterior cervical fusion on neck motion.
abstract: BACKGROUND
  Anterior cervical decompression and fusion (ACDF) procedures are successful in treating multilevel cervical radiculopathy and cervical myelopathy. It was reported that this procedure would result in a loss of cervical range of motion. However, few studies have focused on the exact impact of multilevel (more than 3 levels) ACDF on cervical range of motion.
  
  
  METHODS
  29 patients underwent a 3-level or 4-level ACDF. In all the patients, preoperative active cervical ROM measurement was performed, and postoperative measurement was performed at 1-year follow-up by a CROM device. The pre- and postoperative data were compared to each other using paired t tests (α = 0.05).
  
  
  RESULTS
  The patients had significantly less ROM after the surgery in all planes of motion. Major reduction was observed in flexion (39.5%), left and right lateral flexion (25.7 and 25.9%), with relatively minor impact on extension (18.3%), left and right rotation (14.0 and 14.4%) observed. In the three cardinal planes, major reduction was observed in the sagittal plane (28.2%) and coronal plane (25.8%), while minor impact observed in the horizontal plane (14.1%).
  
  
  CONCLUSIONS
  The patients of cervical spondylotic myelopathy had an obvious reduction in active cervical ROM following multilevel ACDF. However, patients might not experience great difficulties in performing daily activities with regard to the loss of neck motion after fusion.
authors.affiliation: Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China. wxdspine@gmail.com
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Wu
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Yuan
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Tsai
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Peng
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Cong
authors.initials: C
authors.lastname: Wang
authors.forename: Shi-Yi
authors.initials: SY
authors.lastname: Gu
authors.forename: Hua-Jiang
authors.initials: HJ
authors.lastname: Chen
authors.forename: Xu-Hui
authors.initials: XH
authors.lastname: Zhou
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: He
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Chen
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D009333:Neck / Q000000981:diagnostic imaging / Q000502:physiology*; D011843:Radiculopathy / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D013117:Spinal Cord Compression / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome