Recovery Kinetics After Cervical Spine Surgery

Author:

Subramanian Tejas12,Shinn Daniel J.12,Korsun Maximilian K.1,Shahi Pratyush1,Asada Tomoyuki1,Amen Troy B.1,Maayan Omri12,Singh Sumedha1,Araghi Kasra1,Tuma Olivia C.1,Singh Nishtha1,Simon Chad Z.1,Zhang Joshua1,Sheha Evan D.12,Dowdell James E.12,Huang Russel C.1,Albert Todd J.1,Qureshi Sheeraz A.12,Iyer Sravisht12

Affiliation:

1. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY

2. Weill Cornell Medicine, New York, NY

Abstract

Study Design. Retrospective review of a prospectively maintained multisurgeon registry. Objective. To study recovery kinetics and associated factors after cervical spine surgery. Summary of Background Data. Few studies have described return to activities cervical spine surgery. This is a big gap in the literature, as preoperative counseling and expectations before surgery are important. Materials and Methods. Patients who underwent either anterior cervical discectomy and fusion (ACDF) or cervical disk replacement (CDR) were included. Data collected included preoperative patient-reported outcome measures, return to driving, return to working, and discontinuation of opioids data. A multivariable regression was conducted to identify the factors associated with return to driving by 15 days, return to working by 15 days, and discontinuing opioids by 30 days. Results. Seventy ACDF patients and 70 CDR patients were included. Overall, 98.2% of ACDF patients and 98% of CDR patients returned to driving in 16 and 12 days, respectively; 85.7% of ACDF patients and 90.9% of CDR patients returned to work in 16 and 14 days; and 98.3% of ACDF patients and 98.3% of CDR patients discontinued opioids in a median of seven and six days. Though not significant, minimal (odds ratio (OR)=1.65) and moderate (OR=1.79) disability was associated with greater odds of returning to driving by 15 days. Sedentary work (OR=0.8) and preoperative narcotics (OR=0.86) were associated with decreased odds of returning to driving by 15 days. Medium (OR=0.81) and heavy (OR=0.78) intensity occupations were associated with decreased odds of returning to work by 15 days. High school education (OR=0.75), sedentary work (OR=0.79), and retired/not working (OR=0.69) were all associated with decreased odds of discontinuing opioids by 30 days. Conclusions. Recovery kinetics for ACDF and CDR are comparable. Most patients return to all activities after ACDF and CDR within 16 days. These findings serve as an important compass for preoperative counseling.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Orthopedics and Sports Medicine

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