Influence of the Number of Cervical Fusion Levels on Cervical Spine Motion and Health-Related Quality of Life

Sang Hun Lee, Jae Chul Lee, Ryoji Tauchi, K. Daniel Riew

Research output: Contribution to journalArticlepeer-review

Abstract

Study Design. A retrospective study. Objective. To analyze the influence of the number of cervical fusion levels on total cervical motion and health-related quality of life (HRQoL) in patients with solid anterior cervical fusions (ACFs). Summary of Background Data. Few studies have analyzed the degree to which cervical range of motion (ROM) and HRQoL are affected by the number of cervical fusion segments. Methods. We analyzed a cohort of patients who underwent ACF for degenerative disc disease. To assess the clinical outcomes and HRQoL, preoperative, 1-and 2-year postoperative neck and arm pain, visual-analogue scale, neck disability index, and short form-36 were analyzed. Radiographically, C2-7 and C0-2 ROM, C2-7 sagittal vertical axis (SVA), and Kellgren grade of radiographic adjacent segment pathology (RASP) were evaluated. Results. A total of 105 patients (M:F=46:59, mean age of 51.4 yr) were enrolled. There were 36 patients who underwent single-level ACF (group 1), 41 patients who had a double level ACF (group 2), and 28 patients who underwent ACF involving 3 or more levels (group 3). There was no decrease in C2-7 motion in group 1, a mean 7-degree decrease in group 2, a mean 18-degree decrease in those who underwent a 3-level ACF, and a mean 22-degree decrease after 4-level ACF. The grade of RASP was not influenced by the number of fusion levels. All HRQoL parameters showed no significant correlation between number of fusion levels, cervical ROM, and SVA. Conclusion. Single-level ACF showed no decrease in total cervical motion; multilevel ACF decreased cervical motion by a mean of 7.8 degrees per segment of fusion. Progression of RASP showed no correlation with the number of fusion levels. HRQoLs were not influenced by the number of fusion levels, cervical ROM, or SVA after solid ACF. Level of Evidence: 3

Original languageEnglish (US)
Pages (from-to)E474-E480
JournalSpine
Volume41
Issue number8
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Keywords

  • NDI
  • SF-36
  • anterior cervical fusion
  • cervical spine range of motion
  • health-related quality of life
  • myelopathy
  • neck disability index
  • neck motion
  • number of fusion levels
  • radiculopathy
  • radiographic adjacent segment pathology
  • visual analogue scale

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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