De Biase Gaetano, Chen Selby, Bydon Mohamad, Elder Benjamin D, McClendon Jamal, Deen Hugh G, Nottmeier Eric, Abode-Iyamah Kingsley
Neurosurgery, Mayo Clinic, Jacksonville, USA.
Neurosurgery, Mayo Clinic, Rochester, USA.
Cureus. 2020 Aug 3;12(8):e9532. doi: 10.7759/cureus.9532.
No scientific evidence on restrictions for patients following an anterior cervical discectomy and fusion (ACDF) is available. The goal of this study is to assess the practice and patterns of restrictions after single-level and multilevel ACDF at an academic institution. We submitted two questionnaires, for restrictions after single-level and multilevel ACDF, to 18 spine surgeons at our institution. Questions included length of time in practice, use of cervical collar, postoperative restrictions and practices. We received 10 complete responses. Four (40%) of the respondents were in practice for less than 5 years; 3 (30%) 5 or more years, but less than 10; 1 (10%) 10 or more years, but less than 20; 2 (20%) 20 or more years. Only two (20%) surgeons recommend a cervical collar after a single-level ACDF, while seven (70%) do so after a multilevel ACDF, for an average of 9.1 weeks and standard deviation (SD) of 2.8. Nine surgeons (90%) reported providing lifting restrictions after a single-level and multilevel ACDF, with a mean of 10 kg and SD of 2.5 in both cases. 5 (50%) give driving restrictions after a single-level ACDF, eight (80%) do so after a multilevel. eight (80%) recommend physical therapy after both single-level and multilevel ACDF. three (30%) obtain a CT to confirm fusion at one year. Only two (20%) recommend a bone stimulator. Significant variability exists among surgeons in regards to restrictions following ACDF, but some areas of consensus emerged: 90% of respondents give lifting restrictions, with a mean of 10 kg, 80% recommend physical therapy for a range of motion and muscle strengthening.
目前尚无关于颈椎前路椎间盘切除融合术（ACDF）后患者限制措施的科学证据。本研究的目的是评估某学术机构单节段和多节段ACDF术后限制措施的实施情况和模式。我们向本机构的18位脊柱外科医生发放了两份关于单节段和多节段ACDF术后限制措施的问卷。问题包括从业时间、颈托使用情况、术后限制措施及做法。我们收到了10份完整回复。4名（40%）受访者从业时间不足5年；3名（30%）为5年及以上但不足10年；1名（10%）为10年及以上但不足20年；2名（20%）为20年及以上。只有2名（20%）外科医生建议单节段ACDF术后使用颈托，而7名（70%）医生建议多节段ACDF术后使用，平均使用9.1周，标准差（SD）为2.8。9名外科医生（90%）报告称，单节段和多节段ACDF术后均会给出提举限制，两种情况下均值均为10千克，标准差为2.5。5名（50%）医生给出单节段ACDF术后驾驶限制，8名（80%）医生给出多节段ACDF术后驾驶限制。8名（80%）医生建议单节段和多节段ACDF术后均进行物理治疗。3名（30%）医生会在术后一年进行CT检查以确认融合情况。只有2名（20%）医生建议使用骨刺激器。ACDF术后外科医生在限制措施方面存在显著差异，但也出现了一些共识领域：90%的受访者给出提举限制，均值为10千克，80%的医生建议进行物理治疗以恢复活动范围和增强肌肉力量。
