Significant Improvement In Neck Disability Index Research Articles

The Positive Side Effect of Anterior Cervical Decompression and Fusion on Axial Neck Pain.

Observational Cohort Study. This study aims to comprehensively assess the outcomes of anterior cervical spine surgery in patients who have undergone surgical intervention for radiculopathy or myelopathy, with a specific focus on the surgery's impact on axial neck pain. Data from an institutional spine surgery registry were analyzed for patients who underwent anterior cervical spine surgery between January 2016 and March 2022. Patient demographics, clinical variables, and outcome measures, including the Neck Disability Index (NDI), numeric rating scales for neck and arm pain (NRS-Neck and NRS-Arm), and 36-Item Short Form Health Survey (SF-36) scores, were collected. Statistical analysis included paired t-tests, chi-squared tests, and multivariate linear regression. Of 257 patients, 156 met the inclusion criteria. Patients showed significant improvement in NDI, NRS-Neck, NRS-Arm, SF-36 (Physical and Mental components), and all changes exceeded the minimum clinically important difference. Multivariate regression revealed that lower preoperative physical and mental component scores and higher preoperative NRS-Neck predicted worse NDI scores at follow-up. This study underscores that anterior cervical fusion not only effectively alleviates arm pain and disability but also has a positive impact on axial neck pain, which may not be the primary target of surgery. Our findings emphasize the potential benefits of surgical intervention when neck pain coexists with neurologic compression. This contribution adds to the growing body of evidence emphasizing the importance of precise diagnosis and patient selection. Future research, ideally focusing on patients with isolated neck pain, should further explore alternative surgical approaches to enhance treatment options.

A Retrospective Comparative Study of Long-Term Outcomes Following Cervical Total Disc Replacement Versus Anterior Cervical Discectomy and Fusion.

Introduction The traditional treatment for patients with radiculopathy and myelopathy caused by degenerative disc disease was anterior cervical discectomy and fusion (ACDF). However, a documented complication of ACDF is adjacent segment degeneration (ASD). An alternative that was developed was total disc replacement (TDR). The aim of this study was to determine and compare the short- and medium-to-long-term outcomes after a TDR or ACDF. Methods A retrospective review of 154 patients who had single and two-level ACDFs and 90 TDRs performed by a single surgeon between 2011 and 2017 was conducted. Parameters for comparisons include both radiological evaluation and patient-reported outcome measures (PROMS) at six weeks, one year, and two years postoperatively. The Neck Disability Index (NDI) and the visual analogue scale (VAS) for neck and arm pain are used to evaluate pain, function, patient satisfaction, and overall clinical success. Results TDR and ACDF showed significant improvement in NDI and VAS when compared to pre- and post-operatively at both six weeks (p<0.05 & P=0.032, respectively) and two years (p<0.05 & 0=0.026, respectively). TDR vs. ACDF showed no significant difference (p<0.05). VAS scores after ACDF showed improvement from 13.41 to 3.94 at two years (p<0.001). TDR showed similar scores of 12.5 to 3.55 (p<0.001). The radiological fusion rate at 12 or 24 months showed no significant difference between the two groups. There were two cases that required re-operation after ACDF (1.2%), and two that required TDR (2.2%). Conclusion Both TDR and ACDF lead to clinically significant improvements in pain and function scores. We did not find a statistically significant difference in NDI and VAS in the neck and arm. The results are in agreement with others' assessments of these two treatment modalities. Our conclusions supplement the literature about these operative options for degenerative disc disease of the cervical spine and are a useful addition to the armamentarium in the assessment of patients with degenerative pathology of the c-spine.

ProDisc-C versus anterior cervical discectomy and fusion for the surgical treatment of symptomatic cervical disc disease: two-year outcomes of Asian prospective randomized controlled multicentre study.

Our study aimed to evaluate non-inferiority of ProDisc-C to anterior cervical discectomy and fusion (ACDF) in terms of clinical outcomes and incidence of adjacent segment disease (ASD) at 24-months post-surgery in Asian patients with symptomatic cervical disc disease (SCDD). This multicentre, prospective, randomized controlled trial was initiated after ethics committee approval at nine centres (China/Hong Kong/Korea/Singapore/Taiwan). Patients with single-level SCDD involving C3-C7-vertebral segments were randomized (2:1) into: group-A treated with ProDisc-C and group-B with ACDF. Assessments were conducted at baseline, 6-weeks, 3/6/12/18/24-months post-surgery and annually thereafter till 84-months. Primary endpoint was overall success at 24-months, defined as composite of: (1) ≥ 20% improvement in neck disability index (NDI); (2) maintained/improved neurologic parameters; (3) no implant removal/revision/re-operation at index level; and (4) no adverse/severe/life-threatening events. Of 120 patients (80ProDisc-C,40ACDF), 76 and 37 were treated as per protocol (PP). Overall success (PP) was 76.5% in group-A and 81.8% in group-B at 24-months (p = 0.12), indicating no clear non-inferiority of ProDisc-C to ACDF. Secondary outcomes improved for both groups with no significant inter-group differences. Occurrence of ASD was higher in group-B with no significant between-group differences. Range of motion (ROM) was sustained with ProDisc-C but lost with ACDF at 24-months. Cervical TDR with ProDisc-C is feasible, safe, and effective for treatment of SCDD in Asians. No clear non-inferiority was demonstrated between ProDisc-C and ACDF. However, patients treated with ProDisc-C demonstrated significant improvement in NDI, neurologic success, pain scores, and 36-item-short-form survey, along with ROM preservation at 24-months. Enrolment difficulties resulted in inability to achieve pre-planned sample size to prove non-inferiority. Future Asian-focused, large-scale studies are needed to establish unbiased efficacy of ProDisc-C to ACDF.

Establishing the minimum clinically important difference in Neck Disability Index and modified Japanese Orthopaedic Association scores for adult cervical deformity.

It is being increasingly recognized that adult cervical deformity (ACD) is correlated with significant pain, myelopathy, and disability, and that patients who undergo deformity correction gain significant benefit. However, there are no defined thresholds of minimum clinically important difference (MCID) in Neck Disability Index (NDI) and modified Japanese Orthopaedic Association (mJOA) scores. Patients of interest were consecutive patients with ACD who underwent cervical deformity correction. ACD was defined as C2-7 sagittal Cobb angle ≥ 10° (kyphosis), C2-7 coronal Cobb angle ≥ 10° (cervical scoliosis), C2-7 sagittal vertical axis ≥ 4 cm, and/or chin-brow vertical angle ≥ 25°. Data were obtained from a consecutive cohort of patients from a multiinstitutional prospective database maintained across 13 sites. Distribution-based MCID, anchor-based MCID, and minimally detectable measurement difference (MDMD) were calculated. A total of 73 patients met inclusion criteria and had sufficient 1-year follow-up. In the cohort, 42 patients (57.5%) were female. The mean age at the time of surgery was 62.23 years, and average body mass index was 29.28. The mean preoperative NDI was 46.49 and mJOA was 13.17. There was significant improvement in NDI at 1 year (46.49 vs 37.04; p = 0.0001). There was no significant difference in preoperative and 1-year mJOA (13.17 vs 13.7; p = 0.12). Using multiple techniques to yield MCID thresholds specific to the ACD population, the authors obtained values of 5.42 to 7.48 for the NDI, and 1.00 to 1.39 for the mJOA. The MDMD was 6.4 for the NDI, and 1.8 for the mJOA. Therefore, based on their results, the authors recommend using an MCID threshold of 1.8 for the mJOA, and 7.0 for the NDI in patients with ACD. The ACD-specific MCID thresholds for NDI and mJOA are similar to the reported MCID following surgery for degenerative cervical disease. Additional studies are needed to verify these findings. Nonetheless, the findings here will be useful for future studies evaluating the success of surgery for patients with ACD undergoing deformity correction.

Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial.

Background: Chronic neck pain (NP) attributed to myofascial pain syndrome is one of the particularly common skeletal muscle disorder associated with the hyperirritable zone in the taut band of muscle. Trigger points (TPs) are the physical interpretation of the myofascial pain syndrome. In the United States, 30%–85% of pain patients have been affected by myofascial TPs.Objectives: To reveal preliminary evidence on the clinical efficacy of ischemic compression therapy, dry cupping, and their combination on improving the TPs' pressure pain threshold (PPT), neck range of motion (NROM), and neck disability index (NDI) in patients with TPs and nonspecific NP. Besides, assess the feasibility of conducting a randomized clinical trial (RCT).Design: A randomized pilot study was conducted on 24 patients with TPs and nonspecific NP. Patients were randomly assigned to three groups: the cupping group, the ischemic compression group, and the combination therapy group. PPT, NROM, and NDI were assessed before and after 4 weeks of treatment.Results: The results showed a statistically significant improvement in NDI, PPT, and NROM compared with values before the treatment (p < 0.05) in all groups. Although no significant difference was detected between ischemic compression (IC) and dry cupping, the combination approach showed significantly higher and faster improvement (p < 0.05).Conclusions: It is feasible to conduct a main RCT. Both IC and dry cupping may hold promise in treating TPs; a combination of the two therapies may provide superior improving rate.

Effect of Myelopathy on Outcomes After Cervical Disc Replacement: A Study of a Local Patient Cohort and a Large National Cohort

Abstract INTRODUCTION Previous research has shown increased perioperative morbidity after anterior cervical discectomy and fusion (ACDF) for patients with myelopathy. However, the association of myelopathy with outcomes after CDR has not yet been shown. METHODS Consecutive patients undergoing CDR by a single surgeon were identified and patients undergoing CDR in the 2015 and 2016 National Surgical Quality Improvement Program (NSQIP) database were identified. Patients with a preoperative diagnosis of cervical myelopathy were identified in both cohort, and perioperative outcomes and short-term postoperative outcomes were compared between patients with and without myelopathy. Comparisons were also controlled based on the number of levels treated. RESULTS A total of 27 patients were identified in the institutional cohort, 12 patients (44.4%) with myelopathy. A total of 3023 patients were identified in the national cohort, 411 (13%) with myelopathy. In the institutional cohort, the nonmyelopathy group saw significant improvements in neck disability index (NDI), and visual analog scale (VAS) neck and arm pain at both 2 and 6 wk postoperatively. The myelopathy group only saw a significant improvement in NDI at 6 wk (−13.1± 4.1, P &lt; .05) but not at 2 wk (P &gt; .05). In the national cohort, myelopathy was associated with longer operative time and length of stay, even after controlling for the number of levels treated (P &lt; .05). However, there was no significant difference in perioperative complications (P &gt; .05). CONCLUSION Myelopathy is not associated with increased perioperative morbidity and complications after CDR. Significant improvement in patient reported outcomes is seen at 6 wk in myelopathy patients, although more rapid improvement is seen in patients without myelopathy.

The impact of mental health on patient-reported outcomes in cervical radiculopathy or myelopathy surgery

Optimizing functional outcomes and disability status are essential for effective surgical treatment of cervical spine disorders. Mental impairment is common among patients with cervical spine complaints; yet little is known about the impact of baseline mental status with respect to overall patient-reported outcomes. This was a retrospective analysis of patients with cervical spondylosis with myelopathy(CM) or radiculopathy(CR: cervical disc herniation, stenosis, or spondylosis without myelopathy) at 2-year follow-ups. Patients were assessed for several health-related quality of life HRQOL) measures at baseline and 24-months post-operatively: Neck Disability Index (NDI), Visual Analog Scale(VAS), Short Form-36(SF) Physical(PCS) and Mental(MCS) Components. Patients were dichotomized by MCS score: LOW-MCS(SF-MCS < 40th percentile) vs. HIGH-MCS(SF-MCS > 60th percentile). Independent and paired t-tests compared improvement in each group for HIGH-MCS and LOW-MCS cohorts. 375 patients were analyzed(65.4yrs, 67.6%F). LOW-MCS radiculopathy patients showed significant improvement in NDI, VAS Neck and Arm Pain(p < 0.05). HIGH-MCS radiculopathy patients showed greater improvement in NDI score, VAS Neck and Arm Pain, and improvement in PCS(all p < 0.05). Comparing baseline and 2-year follow-up, LOW-MCS CM patients showed significant improvement in PCS, NDI, VAS Neck and Arm Pain(p < 0.05). HIGH-MCS myelopathy patients group showed marked improvement in NDI scores, VAS Neck and Arm Pain(p < 0.05). LOW-MCS CR patients were more likely to be less satisfied 2-years post-op(p < 0.001). Postoperative CR patients with lower baseline mental status saw less improvement and significantly worse outcomes than patients with higher baseline mental status. Improving baseline mental health may improve post-operative recovery. Implementing additional screening and care can optimize functional outcomes and disability status for patients with CR.

Multilevel Cervical Arthroplasty versus Multilevel Fusion in Three-Level Cervical Disc Disease (Clinical and Radiological Outcomes)

Introduction The surgical treatment for cervical disc disease increased in the last decade using different surgical techniques. The percentage of the patients being surgically treated for three-level cervical disc disease remains small therefore the optimal surgical approach for these patients remains the subject of discussion. Multiple cervical disc arthroplasty, multilevel fusion, and hybrid procedures are among the options using the anterior approach. The aim of the study was to compare the multilevel cervical disc arthroplasty and multilevel fusion and compare clinical as well as the radiographic results in patients treated for three-level symptomatic cervical degenerative disc disease 2 years after the surgery. Methods Overall, 23 patients with three-level symptomatic cervical degenerative disc disease were treated with complete anterior cervical discectomy and either with ProDisc-C disc arthroplasty or with fusion using Cervios chronoOS prostheses (ACDF) or standalone cervical cages. Overall 8 multilevel arthroplasty and 14 ACDF's procedures were performed. Clinical outcomes were assessed before and 12 and 24 months after the procedure using neurological examination, the neck disability index (NDI) and visual analogue scale (VAS) for neck and arm pain, with 15% improvement in NDI and 20% in VAS defined as clinically significant. Comparison between both groups (arthroplasty and fusion group) was based on clinical outcomes using neurological examination, VAS, NDI, and patient's satisfaction. Preoperative and postoperative ROMs (range of motion) were evaluated by measuring the lateral and flexion–extension radiographs. Results Both groups had a statistically significant improvement in NDI and VAS for neck and arm pain ( p &lt; 0.05), 2 years after the surgery and the arthroplasty group had a slightly better improvement according to NDI (71.4% of patients in the arthroplasty group achieved ≥ 15% improvement in NDI and 67.5 of patients in ACDF group). The arthroplasty group showed faster recovery of C2 to C7 range of motion. There was a statistically significant difference in the C2 to C7 ROM between the two groups at 12 and 24 months postoperatively ( p &lt; 0.05). The ROM of the arthroplasty group approached the preoperative value at 12 months however it decreased again at 24 months. Conclusions Disc arthroplasty can be an effective alternative in the surgical treatment for the multilevel cervical disc disease, preserving segmental motion after surgery and providing improvement in pain and functional outcome for the patients. The right surgical treatment for the three-level disc disease remains the subject of discussion and more long-term follow-up studies will be needed to determine the definitive treatment.

Anterior Cervical Discectomy versus Posterior Cervical Foraminotomy in the Treatment of Brachialgia: The Leeds Spinal Unit Experience (2008–2013)

Introduction The surgical management of cervical brachialgia utilizing anterior cervical discectomy (ACD) and posterior cervical foraminotomy (PCF) is a controversial area of spine surgery. Few studies have compared the effectiveness of both interventions. These studies were however flawed by utilization of nonvalidated outcome measures, nonstatistical analysis, and importantly lack of preoperative analysis to ensure both groups were matched. Taking this into account, the authors aimed to compare the effectiveness of both surgical interventions using validated outcome measures. It will be the first study in the literature to be doing this. Material and Methods The authors conducted a 5-year retrospective review (2008–2013) of outcome following both the above surgeries and also compared the effectiveness of both techniques. Patients with previous neck surgery, myelopathy, and large central discs were excluded. The main outcome variables measured were Neck Disability Index (NDI), Visual analogue scores (VAS) for neck and arm pain. Wilcoxon signed rank test and student t test were used to test differences. Results A total of 150 ACDs and 51 PCFs were performed for brachialgia. Overall, 26 (17.3%) and 13 (25.5%) patients with ACD and PCF were lost to follow-up, respectively. Median follow-up for the ACD and PCF group were 5 months (range, 1–45 months) and 1 month (range, 1–30 months), respectively. There were no differences in the preoperative NDI, VAS neck, and arm scores between the groups ( p &gt; 0.05). As expected, both ACD and PCF delivered statistically significant improvement in NDI and VAS neck and arm scores. The degree of improvement of NDI, VAS neck, and VAS arm were similar between both the groups of patients ( p &gt; 0.05) with a trend favoring the PCF group. The amount of blood loss and length of operation were comparable between both the groups ( p &gt; 0.05). There was a nonsignificant trend that ACD was effective in compression related to disc and PCF being more effective in foraminal pathology. In the ACD group, two (1.3%) patients needed repeat ACD due adjacent segment disease. One (0.7%) needed further decompression via PCF. Four (2.7%) and seven (4.7%) patients with ACD had hoarse voice and dysphagia respectively all of which improved on follow-up. In the PCF group, one (2.0%) patient needed ACD because of the persistent brachialgia. Conclusion Our study shows that PCF is an alternative to ACD for treating patients with brachialgia with both modalities being equally effective. There were no differences in postoperative neck pain nor need for further surgery between the two procedures however the risks of hoarse voice, dysphagia, and adjacent segment disease could be avoided with PCF. This is the first study to utilize validated outcome measures to prove the effectiveness of PCF and that it is comparable to ACD. This is a medium-sized, single center, unrandomized, and retrospective study. Nevertheless, it is the authors' belief that this study, interpreted in association with previously published studies, provides strong justification for conducting a large multicenter, randomized controlled trial comparing these two treatment options. The authors are currently setting up a prospective clinical trial to help address this question further.

Comparison of one-level microendoscopy laminoforaminotomy and cervical arthroplasty in cervical spondylotic radiculopathy: a minimum 2-year follow-up study

BackgroundThis study aims to compare the perioperative parameters and clinical results between microendoscopy laminoforaminotomy (MELF) and cervical arthroplasty (CA) in the treatment of one-level cervical spondylotic radiculopathy in a retrospective study.MethodsFrom 2003 to 2007, a total of 97 patients with one-level cervical spondylotic radiculopathy were treated. Forty-five patients underwent CA. Fifty-two patients underwent MELF. Patient demographics and operative data were collected with a minimum 2-year follow-up. Perioperative parameters were compared. Clinical assessment in terms of neck disability index (NDI), short form (SF)-36, and visual analogue scale (VAS) of arm pain and neck pain was performed prior to surgery and at 1.5, 3, 6, 12, and 24 months after surgery.ResultsFluoroscopy time (CA, 60.3 s; MELF, 12.1 s; P < 0.01) and surgical time (CA, 95.1 min; MELF, 24.0 min; P < 0.01) were significantly longer in the CA cases. Shorter hospitalized days (CA, 1.1 days; MELF, 0.13 days; P < 0.01) and less estimated blood loss (EBL; CA, 75.8 ml; MELF, 31.9 ml; P < 0.01) were observed in the MELF group. Both CA and MELF groups showed significant improvement in NDI, VAS of neck pain and arm pain, and SF-36 (P < 0.05 for each) at 1.5, 3, 6, 12, and 24 months after surgery, but there was no significant difference between them (P > 0.05).ConclusionsAs alternatives of anterior cervical decompression and fusion (ACDF), both CA and MELF can produce satisfactory clinical outcomes. MELF has the additional benefits of less blood loss, less surgical time, less X-ray time, and shorter hospital stay.

Fluoroscopic Cervical Interlaminar Epidural Injections in Managing Chronic Pain of Cervical Postsurgery Syndrome: Preliminary Results of a Randomized, Double-Blind, Active Control Trial

Background: Cervical postsurgery syndrome is common with increasing cervical surgical interventions. Cervical spine surgery may fail in a certain proportion of patients with continued pain secondary to pseudoarthrosis, adjacent segment degeneration, inadequate decompression, iatrogenic instability, facet joint arthritis, deformity, and spinal stenosis. Among the various treatments available for managing cervical postsurgery syndrome, epidural steroid injections are one of the most common nonsurgical interventions. However there have not been any systematic evaluations regarding the effectiveness of cervical epidural injections in cervical postsurgery syndrome. Study Design: A randomized, double-blind, active control trial. Setting: A specialty referral, private interventional pain management practice in the United States. Objectives: To evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids in providing effective and long-lasting relief in the management of chronic neck pain and upper extremity pain in patients with cervical postsurgery syndrome, and to evaluate the differences between local anesthetic with or without steroids. Methods: Patients were randomly assigned to one of 2 groups: Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL); Group II patients received cervical interlaminar epidural injections with 0.5% lidocaine, 4 mL, mixed with 1 mL of nonparticulate betamethasone. The study was designed to include 120 patients with 60 patients in each group. This analysis includes 56 patients. Randomization was performed by computer-generated, random allocation sequence by simple randomization. Outcomes Assessment: Outcome measures included the Numeric Rating Scale (NRS), the Neck Disability Index (NDI), employment status, and opioid intake. Assessments at baseline and 3, 6, and 12 months posttreatment. Significant pain relief was defined as 50% or more; significant improvement in NDI was defined as a reduction of 50% or more. Results: Significant pain relief (≥ 50%) was demonstrated in 71% of patients in Group I and 68% of patients in Group II. Functional status improvement was demonstrated by a reduction (&gt; 50%) in the NDI scores in 71% of Group I and 64% of Group II at 12 months. The overall average procedures per year were 4.0 ± 0.7 in Group I and 4.1 ± 1.0 in Group II; the average total relief per year was 39.6 ± 11.8 weeks in Group I and 41.2 ± 15.8 weeks in Group II over the 52 week study period in the patients defined as successful. In the successful group, the combined pain relief and neck disability improvement was seen in 87% in Group I and 72% of the patients in Group II. Limitations: The study results are limited by the lack of a placebo group and a preliminary report of 56 patients, 28 in each group. Conclusion: Cervical interlaminar epidural injections with local anesthetic with or without steroids were effective in 67% of patients overall and 87% in Group I and 72% in Group II, in successful group patients with chronic function-limiting neck pain and upper extremity pain secondary to cervical postsurgery syndrome. Key words: Chronic neck pain, upper extremity pain, cervical disc herniation, cervical spinal stenosis, cervical postsurgery syndrome, cervical epidural injections, epidural steroids, local anesthetics.

ProDisc-C versus fusion with Cervios chronOS prosthesis in cervical degenerative disc disease: Is there a difference at 12 months?

Study design: Prospective cohort study.Objective: The aim of the study was to compare clinical results and to determine differences in outcomes between anterior cervical discectomy and fusion (ACDF) and disc arthroplasty in patients treated for symptomatic cervical degenerative disc disease.Methods: Forty patients with cervical degenerative disc disease were treated with ProDisc-C disc arthroplasty and 40 patients with fusion using an intervetebral spacer with integrated fixation (Cervios chronoOS) implants without additional anterior fixation. Fifty disc prostheses were placed in the first group and 52 intervertebral spacers were implanted in the second group. Clinical outcomes were assessed before and 12 months following the procedure using the neck disability index (NDI) and visual analog scale (VAS) for neck and arm pain, with 15% improvement in NDI and 20% in VAS defined as a clinically significant.Results: Eighty patients with cervical degenerative disc disease with a mean age of 49.7 years were included in the study with a minimum follow-up of 12 months. The groups were similar at baseline both clinically and statistically (P > .05) except for age and VAS for arm pain. Both groups had a statistically significant improvement in NDI and VAS for neck and arm pain (P < .05) and the arthroplasty group had a better improvement according to NDI (74.3% of patients in the arthroplasty group achieved ≥15% improvement in NDI versus 65.7% of patients in ACDF group).Conclusions: Both ProDisc C and Cervios chronoOS prostheses resulted in significant pain reduction and functional outcome for the patients with slightly better results in the group treated with disc arthroplasty 12 months after the surgery.Methods evaluation and class of evidence (CoE)Methodological principle:Study Design RCT Cohort study• Case control Case seriesMethods Concealed allocation (RCT) Intent to treat (RCT) Blinded/independent evaluation of primary outcome• Follow-up ≥85%• Adequate sample size• Control for confoundingEvidence class:IIIThe definiton of the different classes of evidence is available on page 83.

A Retrospective Analysis of Patient Perceived Outcomes in Patients 55 Years and Older Undergoing Anterior Cervical Discectomy and Fusion

Retrospective review of clinical outcomes after anterior cervical discectomy and fusion (ACDF) surgery with allograft and plating in patients over 55 years of age. To evaluate the results of ACDF surgery in patients aged 55 years and older. ACDF surgery has been a standard treatment for cervical degenerative and herniated disc disease for many years. Previous assessments of efficacy have used patient perceived outcome measures including the Neck Disability Index (NDI) and the Short Form 36 Question Health Questionnaire (SF-36). Patient perceived outcome after ACDF surgery in an age-specific cohort (55 y and older) has not been documented previously. Fifty-two consecutive patients over 55 years of age who underwent 1 to 3 level ACDF with allograft and plating were identified. Patient perceived outcome questionnaires (NDI and SF-36) were available for 44 patients. There were 28 females and 16 males. Mean age at time of surgery was 61.8 years. Average length of follow-up was 25.2 months (12 to 54 mo). All but one patient demonstrated radiographic healing of the fusion site at the time of their last follow-up. The mean improvement of these 10 groups (total NDI score) was statistically significant (difference =-9.47, t=5.6390, P=1.5198E-06). There was a statistically significant decrease in disability in 7 of the 8 SF-36 categories as well. The mean of the 8 SF-36 categories (total SF-36) improved significantly (improvement=11.92, t=-3.6857, P=0.0007). On the basis of our statistically significant improvement in NDI and SF-36 scores, as a measure of patient perceived outcome after ACDF surgery, outcomes after ACDF surgery in patients over 55 years of age are not significantly different than those of a younger patient population.