title: Evaluation of physical function in individuals 11 to 14 years after anterior cervical decompression and fusion surgery--a comparison between patients and healthy reference samples and between 2 surgical techniques.
abstract: OBJECTIVE
  The purpose of this study was to evaluate neck-related physical function in individuals 11 to 14 years after anterior cervical decompression and fusion (ACDF) surgery for degenerative cervical disk disease and to compare the long-term outcome of 2 surgical techniques, including the Cloward procedure and cervical intervertebral fusion cage.
  
  
  METHODS
  In this cross-sectional study, 51 individuals, 11 years or more after ACDF, underwent testing of cervical active range of motion, hand-grip strength, static and dynamic balance, neck muscle endurance, and completed pain ratings. The participants' values were compared with values of age- and sex-matched healthy individuals to evaluate impairments. Correlations between different test scores and pain were performed. Group differences were analyzed between the 2 surgical techniques.
  
  
  RESULTS
  Sixty-five percent and 82% exhibited impairment in ventral and dorsal neck muscle endurance, respectively. Impairment rates of 18% to 39% for cervical active range of motion, 27% to 43% for hand-grip strength, 37% for standing balance, and 35% for dynamic balance were recorded. Twenty-nine percent of the participants had impairment (>30 mm visual analog scale) in pain. There were no significant differences in physical function between the 2 surgical treatment groups (Cloward procedure or cervical intervertebral fusion cage) (P = .10-.92).
  
  
  CONCLUSIONS
  In those studied, a large percentage of patients who had anterior cervical decompression and fusion surgery have impairments in neck-related physical function when compared 11 to 14 years after surgery with age- and sex-matched healthy reference individuals. Neck-specific function, but not balance, was statistically correlated to pain. Neck muscle endurance was most affected, and balance impairments were also present in one-third of the individuals. There were no differences in long-term physical function between the 2 surgical techniques.
authors.affiliation: PhD Student, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Anna M K
authors.initials: AM
authors.lastname: Hermansen
authors.affiliation: Professor, Physical Therapy Department, Franklin Pierce University, Concord, NH.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Cleland
authors.affiliation: Senior Lecturer, Futurum-the Academy for Healthcare, County Council, Jönköping, Sweden; Senior Lecturer, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Ann-Sofi C
authors.initials: AS
authors.lastname: Kammerlind
authors.affiliation: Associate Professor, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden. Electronic address: Anna.hermansen@liu.se.
authors.forename: Anneli L C
authors.initials: AL
authors.lastname: Peolsson
mesh_terms: D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000601:surgery*; D003430:Cross-Sectional Studies; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D009334:Neck Muscles / Q000503:physiopathology; D019547:Neck Pain / Q000503:physiopathology; D010807:Physical Endurance / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D013123:Spinal Fusion / Q000379:methods*; D064232:Visual Analog Scale
keywords: Cervical Vertebrae; Neck Muscles; Physical Endurance; Postural Balance; Range of Motion; Surgical Procedure