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Disabil Rehabil. 2006 Jan 30;28(2):117-24.

Can the results 6 months after anterior cervical decompression and fusion identify patients who will have remaining deficit at long-term?

Author information

1
Department of Health and Society, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Sweden. Anneli.Peolsson@ihs.liu.se

Abstract

PURPOSE:

There is no knowledge if short-term outcome in patients after anterior cervical decompression and fusion (ACDF) can be used to identify which patients have remaining deficit in long term. This study investigates if 6-month outcome with a broad assessment after ACDF with a cervical intervertebral fusion cage can be a guide for the 3-years outcome.

METHOD:

A prospective study. Questions about background data, pain, numbness, neck specific disability, distress, sick leave, health, symptom satisfaction and effect of and satisfaction with surgery were asked 28 patients 3 years after ACDF. Measurements have earlier been obtained before and 6 and 12 months after ACDF.

RESULTS:

Compared with the results before surgery patients had improved in pain intensity (p = 0.001), neck pain (0.001), numbness (p = 0.02) and were more 'satisfied' with having their neck problems (p = 0.01). Except for a worsening in expectations of surgery fulfilled (p = 0.04) there were no significant differences between 6-month and 3-year outcome. Three years after ACDF about two-thirds of the patients had remaining deficit with regard to pain intensity, Neck Disability Index, Distress and Risk Assessment Method and general health. According to the parameters studied 50 - 78% of those who at the 6-month follow-up were without deficit were still healthy at the 3-year follow-up. For patients with deficit at 6-month follow-up, still 83 - 100% had deficit 3 years after surgery.

CONCLUSIONS:

Despite a rather small study obtained the stability of 6-month and 3-year results indicates that short-term results might be sufficient for evaluating effects of the treatment. Since the patients in this study clearly demonstrate broad problems array of development of more structured multi-professional rehabilitation models including exercises which improve neck muscle strength, endurance and proprioception need to be introduced.

PMID:
16393842
DOI:
10.1080/09638280500163752
[Indexed for MEDLINE]

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