Recovery after Disc Surgery in the Neck
A herniated disc in the neck can cause pain and loss of motion and strength. Surgery to remove the disc and fuse the problem part of the spine is one way to help relieve pain and improve function.
A group of doctors in Finland studied patients after anterior cervical discectomy and fusion. This surgery is done from the front (anterior) of the neck. A painful disc is removed, and the vertebrae just above and below are fused.
Physical therapists measured muscle strength, range of motion, and grip strength. All measures were taken before and after surgery. Two groups were included: a group of patients who had the surgery, and a control group. There were 53 people in each group. The control group had subjects of the same age, sex, weight, and height as the patient group. Control subjects didn't have any neck pain or disc problems.
Before the operation, 89 percent of the disc patients had altered sensation in the arms. Other signs of nerve compression were also reported. After the discectomy the patients had much less motion and neck strength than the control group. Almost half had continued pain. There was no difference in grip strength between the two groups.
The authors conclude that loss of motion wasn't just caused by pain. They think the fusion (designed to limit motion at that segment of the spine) added to the loss. It's possible that other disc problems and wearing a collar after the operation also reduced neck motion.
Just over half of the patients (57 percent) recovered after disc surgery. This left many patients still suffering from chronic neck pain. They had decreased neck motion, strength, and function. The researchers think early screening may be needed. And they suggest that the benefits of a rehab program for these patients needs to be studied.
Jari J. Ylinen, MD, et al. Decreased Strength and Mobility in Patients after Anterior Cervical Diskectomy Compared with Healthy Subjects. In Archives of Physical Medicine and Rehabilitation. July 2003. Vol. 84. No. 7. Pp. 1043-1047.
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