Rehabilitation and Aftereare ofthe Patient after Cervical Disc Replacement and IntervertebralFusion

Overview

Increasing number of cervical spine procedures highlights a question of proper aftercare andpostoperative rehabilitation. However, the evidence justifying any physiotherapeutical programfollowing the anterior cervical discectomy and fusion is in fact very weak. The authors suggest thatthorough postoperative rehabilitation is advisable to help patients resume daily activities and toprevent acceleration of degenerative changes in adjacent segments.The aim of rehabilitation is a restoration of postural stability in cervical spine region.The programmeconsists of nuchal muscles isometric strengthening and training of those dysfuntive muscles thatparticipate at the pathologic motion stereotype. All the excersices are performed in active sittingposition with increased intensity. Very important part of the rehabilitation is, of course, patient’smotivation.However the rigid cervical collar has been a great addition to the successful management of cervicalspine after the anterior cervical fusion in the past, contemporary methods of internal stabilizationexclude its use.As its prolonged wearmay cause muscle atrophy and cervical spine sagital ballancederangement, authors would go as far as to say that its excessive use may be even deleterious.

Key words:
anterior cervical fusion, internal fixation, bracing, postoperative rehabilitation