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  4. Anterior Fusion and Long-Term Cervical Mobility in Patients With Traumatic Spinal Cord Injury: An Observational Study

Anterior Fusion and Long-Term Cervical Mobility in Patients With Traumatic Spinal Cord Injury: An Observational Study

Cureus, 2023 · DOI: 10.7759/cureus.45549 · Published: September 19, 2023

Spinal Cord InjurySurgeryRehabilitation

Simple Explanation

This study investigates how cervical fusion, a surgery to stabilize the neck after a spinal cord injury, affects the range of motion in the neck. The research compares the neck mobility of patients who had this surgery with that of healthy adults to see how much the surgery limits movement. The findings help understand the challenges these patients face during rehabilitation and suggest ways to improve their therapy to address specific limitations in neck movement.

Study Duration
2003 to 2018
Participants
89 patients with traumatic spinal cord injury (SCI) and cervical subaxial fusion surgery
Evidence Level
Observational Study

Key Findings

  • 1
    Fusion length and age were independently negatively correlated with the cervical range of motion.
  • 2
    Patients with traumatic SCI and intervertebral fusion suffer from significant impairment of mobility in different degrees of movement compared to healthy adults.
  • 3
    Rotation to the right was determined to be significantly higher in multi-level ACIF patients as opposed to combined approaches

Research Summary

The study on 89 patients with cervical SCI and anterior fusion showed significant limitations in their cervical mobility compared to healthy adults. Fusion length and age negatively correlated with cervical range of motion, particularly affecting reclination, tilt, and rotation. The degree of rotational impairment was found to correlate positively with functional outcome, suggesting targeted rehabilitation strategies may improve patient outcomes.

Practical Implications

Rehabilitation Strategies

Occupational and physical therapy should be adapted to address specific limitations in cervical range of motion, especially rotation, to improve functional outcomes.

Surgical Approach Considerations

Surgeons should consider the potential impact of the surgical approach (anterior vs. combined) on post-operative cervical mobility, particularly rotation.

Assistive Technology

Customized assistive devices (e.g., wheelchairs with modified controls) may be beneficial to compensate for rotational impairments and enhance independence.

Study Limitations

  • 1
    Monocentric design may create institutional bias.
  • 2
    Rehabilitation processes are highly individual
  • 3
    Utilization of goniometers has inherent reliability problems

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