Recovery Kinetics Following Cervical Spine Surgery

Retrospective review of a prospectively maintained multi-surgeon registry.To study recovery kinetics and associated factors following cervical spine surgery.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.Patients that underwent either anterior cervical discectomy and fusion (ACDF) or cervical disc 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 for discontinuing opioids by 30 days.70 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 7 and 6 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), retired/not working (OR=0.69) were all associated with decreased odds of discontinuing opioids by 30 days.Recovery kinetics for ACDF and CDR as comparable. Most patients return to all activities following ACDF and CDR, within 16 days. These findings serve as an important compass for preoperative counseling.