Neck motion following multilevel anterior cervical fusion: comparison of short-term and midterm results.
OBJECTIVE
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.
Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Xiao-Dong
XD
Wu
Wen
W
Yuan
Hua-Jiang
HJ
Chen
Yu
Y
Chen
Jian-Xi
JX
Wang
Peng
P
Cao
Ying
Y
Zhang
Xin-Wei
XW
Wang
Li-Li
LL
Yang
Yuan-Yuan
YY
Chen
Nicholas
N
Tsai
D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000209:etiology / Q000503:physiopathology; D011184:Postoperative Period; D016059:Range of Motion, Articular / Q000502:physiology*; D013117:Spinal Cord Compression / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D055009:Spondylosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome