Predictive Factors for Cervical Fusion

Cervical fusion is sometimes used to treat severely injured cervical spinal fractures and disc disease. Some people have a reasonable recovery while others do not. In one study, a total of ninety-five patients were studied who had a cervical intervertebral fusion cage placed – also known as a Cloward Procedure.  The follow-up time was around 19 months for a short-term follow-up, and the patients were then followed for 76 months on average for a long-term follow-up. They looked at the patients’ background, what their radiology films looked like, the treatment type, the physiological measures and the degree of pain and disability prior to the procedure.

The predictors for good follow-up status included non-smokers, low peri-operative pain intensity, low pre-operative disability, male gender, good hand strength and a good range of motion before the surgery. X-ray findings did not predict the outcome of the patient.

Decompression of the cervical spine along with fusion of the c-spine is largely a successful procedure for cervical spinal injury, however some patients still have symptoms after the rehabilitation from the procedure. Doctors want to know who will have symptoms afterward and who will not, particularly that of a radiculopathy. Young males with soft disc disease on one level have the best chance of recovery.

Another study of 23 patients found that active range of motion, hand grip strength and rating well on the Neck Disability Index indicated that the person was likely to do well after cervical fusion. Males, non-smokers, those with low pain and a normal rating on the Distress and Risk Assessment Method (DRAM) did the best post-operatively.