The effects of rehabilitation following anterior cervical microdiscectomy and fusion surgery

Cerezci, Onder; Başak, Ahmet Tulgar

doi:10.5137/1019-5149.jtn.36243-21.2

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Cerezci et al, also in their study, described ODI ranging from 86% to 20% in the pre-and post-operative periods, respectively, demonstrating statistical significance in the result. 19 The present study also found statistically significant figures ranging from 80% in the pre--operative period to 18% in the third postoperative month.…”

Section: Discussionsupporting

confidence: 79%

“…18 In their case series, Cerezci et al described a variation in cervical VAS from 10 preoperatively to 1 postoperatively. 19 In our study, we found a significant variation in the two groups, ranging from 8 preoperatively to 1 postoperatively from the third postoperative month onwards. Cerezci et al, also in their study, described ODI ranging from 86% to 20% in the pre-and post-operative periods, respectively, demonstrating statistical significance in the result.…”

Section: Discussionmentioning

confidence: 45%

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Cervical Anterior Arthrodesis: Autologous or Synthetic Graft?

Soligo Júnior,

Kulcheski,

Santoro

et al. 2024

Coluna/Columna

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Objective: To compare patients who underwent anterior cervical arthrodesis with autologous iliac crest graft and those who used synthetic graft. Methods: Analysis of 38 patients aged between 18 and 100 years with anterior cervical spondylosis of 1 or 2 levels in a spine surgery service. Results: degenerative cervical spine changes associated with cervicalgia and cervicobrachialgia. Excluded: previous cervical spine surgeries, fractures, or surgery above two levels. Two groups were formed with 19 patients, one using autologous graft and the other using synthetic tricalcium phosphate - a questionnaire assessed satisfaction (Oswestry and VAS) pre- and postoperatively. Bone consolidation was evaluated by tomography at nine months. Results: Mean ODI (Group 1) was 68.5% ± 4.6% preoperatively and 27.2% ± 3.8% postoperatively, being statistically relevant (p<0.001). VAS performed to evaluate the cervical region, Group 1 pre and post-op was considered statistically relevant (p<0.001). No significant difference was observed when comparing the mean values found in the postoperative period between Group 1 and Group 2 (p=0.463). Only two patients complained of chronic pain, representing 10% of the total. In nine-month tomography, 100% of patients in Group 1 and 100% of Group 2 showed bone consolidation, with no statistically relevant difference (p=0.676) between the groups. Conclusion: Similar functional and osteointegration outcomes were observed in both types of grafts. Synthetic graft minimizes the risks and complications of using allografts. Level of Evidence III; Retrospective comparative study.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 45%

Cervical Anterior Arthrodesis: Autologous or Synthetic Graft?

Soligo Júnior,

Kulcheski,

Santoro

et al. 2024

Coluna/Columna

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“…Both interventions significantly improved symptoms from baseline in most of the studies, with no inter-group significant difference. Current evidence demonstrates that any therapy is superior to no intervention postoperatively for cervical spondylosis patients following cervical fusion [ 32 ]. This systematic review, demonstrating equivocal improvement in patient outcomes between augmented or targeted therapy and standard postoperative therapy for patients with cervical spondylosis following cervical fusion, is consistent with the current evidence [ 32 ].…”

Section: Reviewmentioning

confidence: 99%

“…Postoperative therapy has been demonstrated to improve outcomes without deleterious effects on instrumentation in cervical fusion [ 32 ]. In this systematic review, augmented and targeted therapies improved patient catastrophizing and satisfaction postoperatively, particularly in the Coping Strategies Questionnaire - Catastrophizing Scale (CSQ-CAT) score.…”

Section: Reviewmentioning

confidence: 99%

Postoperative Rehabilitation to Improve Outcomes After Cervical Spine Fusion for Degenerative Cervical Spondylosis: A Systematic Review

Ling¹,

Thirumavalavan²,

Shin³

et al. 2023

Cureus

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Postoperative rehabilitation has recently been identified as a high-priority research topic for improving surgical outcomes for degenerative cervical spondylosis (DCS). However, there remains no consensus on specific rehabilitation strategies. Thus, the objective of this study was to evaluate the effectiveness of postoperative rehabilitation strategies for short-term and long-term outcomes after cervical spine fusion for DCS. A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines using the PubMed, Scopus, and Ovid Medline databases. All level I-IV therapeutic studies in the English language investigating the outcomes of postoperative rehabilitation strategies after cervical spine fusion for DCS were included. Nine studies with 895 patients with DCS (747 anterior-only fusion, 55 patients with posterior-only fusion, 93 patients with physiotherapy alone) were included in this analysis, with 446 (49.8%) patients receiving physiotherapy alone or standard postoperative therapy and 449 (50.2%) patients receiving standard postoperative therapy with additional intervention or augmentation. These interventions included pulsed electromagnetic field (PEMF) stimulation, telephone-supported home exercise program (HEP), early cervical spine stabilizer training, structured postoperative therapy, and a postoperative cervical collar. One level II study demonstrated that PEMF led to increased fusion rates at six months postoperatively compared to standard therapy alone, one level II study demonstrated that postoperative cervical therapy in addition to standard therapy was better than standard therapy alone in the improvement of neck pain intensity, one level IV study demonstrated home exercise therapy led to an improvement in neck pain, arm pain, and disability, and six level II studies reported no difference in clinical outcome measures between augmented or targeted therapy and standard postoperative therapy for DCS. In conclusion, there is moderate evidence to suggest that there is no significant difference in clinical and surgical outcomes between standard postoperative therapy and augmented or targeted postoperative therapy for cervical fusion in the setting of cervical spondylosis. However, there is some evidence to support that certain therapeutic modalities, such as PEMF stimulation, may lead to improved fusion rates, clinical outcomes, and patient satisfaction when compared to standard postoperative therapy protocols. There is no evidence to support a difference in effectiveness with different types of postoperative rehabilitation strategies between anterior and posterior fusions for DCS.

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“…The current literature evaluating the benefits of post-operative PT using patient-reported outcomes (PROs) is limited and remains inconclusive [17][18][19]. Additionally, PROs have historically been measured using such tools as general health questionnaires (Medical Outcomes Study Short Form), pain rating scales (VAS), or disease-specific questionnaires (NDI, Oswestry Disability Index).…”

Section: Introductionmentioning

confidence: 99%

Post-Operative Physical Therapy Following Cervical Spine Surgery: Analysis of Patient-Reported Outcomes

Lorentz¹,

Galetta²,

Zabat³

et al. 2023

Cureus

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Introduction Post-operative physical therapy (PT) following anterior cervical discectomy and fusion (ACDF) surgery is often performed to improve a patient's functional ability and reduce neck pain. However, current literature evaluating the benefits of post-operative PT using patient-reported outcomes (PROs) is limited and remains inconclusive. Here we compare post-operative improvement between patients who did and did not undergo formal PT after ACDF using Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Methods A retrospective observational study examining patients who underwent one- or two-level primary ACDF or cervical disc replacement (CDR) at an academic orthopedic hospital and who had PROMIS scores recorded pre-operatively and through two-year follow-up. Patients were stratified according to whether or not they attended formal postoperative PT. PROMIS scores and patient demographics were compared using the Mann-Whitney U test, Fisher’s exact test, chi-square test of independence, and Student’s t-test within and between cohorts. Results Two hundred and twenty patients were identified. Demographic differences between PT and no PT groups include age (PT 54.1 vs. no PT 49.5, p=0.005) and BMI (PT 28.1 vs. no PT 29.8, p=0.028). The only significant difference in post-operative PROMIS scores was in physical health scores at three months post-operatively (no PT 43.9 vs. PT 39.1, p=0.008). Physical health scores improved from baseline to one-year follow-up in both cohorts (PT +3.5, p=0.025; no PT +6.6, p=0.008). There were no significant differences when comparing improvements in physical health scores between groups at six months and one year. Conclusion In conclusion, there was no significance to support the benefits of post-operative PT as measured by PROMIS scores. No significant differences in PROMIS were observed between groups from pre-operative baseline scores to six-month and one-year follow-ups.

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The effects of rehabilitation following anterior cervical microdiscectomy and fusion surgery

Cited by 6 publications

References 20 publications

Cervical Anterior Arthrodesis: Autologous or Synthetic Graft?

Cervical Anterior Arthrodesis: Autologous or Synthetic Graft?

Postoperative Rehabilitation to Improve Outcomes After Cervical Spine Fusion for Degenerative Cervical Spondylosis: A Systematic Review

Post-Operative Physical Therapy Following Cervical Spine Surgery: Analysis of Patient-Reported Outcomes

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