Abstract
PurposePopulation aging and certain behaviors associated with modern life are contributing factors for the increasing incidence of degenerative cervical spine conditions (DCSC), and the number of cervical spine surgeries every year is. Our aim was to determine, with an original research protocol, the impact of ACDF and physiotherapy on the range of motion and EMG parameters of patients suffering from DCSC. Patients and MethodsTwo comparable subgroups of 29 patients each were recruited for the present investigation. The first cohort was composed of ACDF patients, whereas the second cohort was composed by healthy subjects. Inclinometry/Range of Motion (RoM) analyses of the neck, and cervical muscles electromyography (EMG) were used to evaluate the neck mobility. We investigated the effects of physiotherapy on ROM and EMG results in order to identify possible significant differences between healthy subjects and ACDF patients. ResultsA total of 58 patients were included in the final cohort. Extensive statistical analysis disclosed that higher NDI values were associated with a reduction of the Extension and Rotation movements, NDI scores, were found to be negatively associated to EMG voltages for Rotation, independently of the physiotherapy performed either. Extension, Lateral Bending, and Rotation showed significant improvement after just one session of physiotherapy, whereas Flexion and Extension proved to be those that contributed most to the overall neck mobility. ConclusionThe cervical spine fusion contributes to an overall reduction of cervical mobility. This data is confirmed by inclinometer and EMG parameters. Physiotherapy increases neck mobility thus possibly improving the clinical status of patients.
Highlights
IntroductionPopulation aging and certain modern behaviors which contribute to bad neck posture, such as excessive use of tablets and cell-phones [1,2], are connected to the increased incidence of degenerative pathologies of the cervical spine, and associated myelopathies and radiculopathies [3,4,5]
The first cohort was composed of anterior cervical discectomy with fusion (ACDF) patients, whereas the second cohort was composed by healthy subjects
We investigated the effects of physiotherapy on ROM and EMG results in order to identify possible significant differences between healthy subjects and ACDF patients
Summary
Population aging and certain modern behaviors which contribute to bad neck posture, such as excessive use of tablets and cell-phones [1,2], are connected to the increased incidence of degenerative pathologies of the cervical spine, and associated myelopathies and radiculopathies [3,4,5]. Conservative treatments such as physio-kinesiotherapy have yielded significantly positive results in individuals affected by degenerative pathology of the cervical spine without significant neurological disor ders, but not in all patients. Among the available surgical treatments, the most commonly used is the anterior cervical discectomy with fusion (ACDF) [6,7,8,9], which en sures good decompression of the spinal cord and roots, halts the degenerative process, and can even lead to an improvement of the Abbreviations: ACDF, Anterior cervical discectomy and fusion; EMG, Electromyography; RoM, Range of Motion; NDI, Neck Disability Index; AUC, Area Under Curve; CT, Computed Tomography; MRI, Magnetic resonance imaging
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