Decreased strength and mobility in patients after anterior cervical diskectomy compared with healthy subjects

Objective: To evaluate whether patients acquired normal physical function after cervical disk prolapse and surgery compared with healthy matched controls. Design: Cross-sectional study. Setting: Hospital in central Finland. Participants: Fifty-three patients with cervical diskectomy and 53 healthy matched controls. Interventions: Not applicable. Main Outcome Measures: Postoperative physical function was studied by measuring muscle strength and range of motion (ROM) values of the neck and grip strength. Disability was assessed by the neck and shoulder pain index and by the Oswestry index, mood by the Short Depression Inventory; and pain on a visual analog scale (VAS). Results: Most patients recovered well after the operation. Forty-three percent of the patients still experienced moderate or high pain (VAS score, >30mm). Subjective pain and disability were associated with decreased neck movement and strength. Both ROM and cervical muscle strength values were significantly lower (P<.001) in all the measured directions in cervical disk surgery patients compared with healthy controls. ROM was mostly confined in extension (25%). Muscle strength of the neck was mostly confined in both rotation directions (38%). No statistically significant difference in grip strength was found between the groups. Conclusion: The loss of muscle strength and ROM is clearly visible postoperatively and thus the effectiveness of the early identification and rehabilitation of these deficits merits further studies.