TITLE:
Multilevel Anterior Cervical Decompression and Fusion: Cervical Range of Motion and Clinical Outcomes
AUTHORS:
Ahmed Hosameldin, Abdelrahman Senosi, Mostafa Abdel-Latif
KEYWORDS:
Multilevel, Anterior Cervical Discectomy, Fusion, Cervical Range of Motion
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.4,
September
28,
2022
ABSTRACT: Background: Multiple level anterior cervical discectomy and
fusion (ACDF) is indicated for those who suffer
from multilevel stenosis or compression of the spinal canal. It was reported
that this intervention would unfortunately lead to a loss of normal cervical
range of motion (CROM). Although, fewer studies have demonstrated the exact
impact of the procedure on CROM. In our study, short and midterm postoperative
CROM was described. Methods:
Ninety patients who underwent ACDF were followed up postoperatively for at
least 3 months. Active CROM was measured in all patients preoperatively and in
postoperative follow-ups by cervical spine X-rays in lateral dynamic view using Cobb’s angle method. Results: Unfortunately, postoperative CROM was significantly diminished. At the short-term (3 months)
follow-up there was a great limitation in CROM. While an obvious increase in
CROM at the midterm (6 months) follow-up was observed in flexion especially. The reduction in global ROM (calculated as
preoperative global ROM – 6 months postoperative ROM) was 4.1 and the
reduction rate (calculated as reduction ROM divided by preoperative ROM) was
9.5%. The recovery ROM (calculated as 6 months postoperative ROM – 1 month
postoperative ROM) was 8.2. The recovery rate (calculated as recovery ROM
divided by 1 month postoperative ROM) was 26.5%. Conclusion: Active CROM following multiple level ACDF was
obviously diminished. The most affected motion after surgery was flexion. It
was noticed that at the short-term follow-up CROM would be more limited while
after further follow up CROM was obviously improved even in neck flexion motion.