• Tejas Subramanian, Daniel J Shinn, Maximilian K Korsun, Pratyush Shahi, Tomoyuki Asada, Troy B Amen, Omri Maayan, Sumedha Singh, Kasra Araghi, Olivia C Tuma, Nishtha Singh, Chad Z Simon, Joshua Zhang, Evan D Sheha, James E Dowdell, Russel C Huang, Todd J Albert, Sheeraz A Qureshi, and Sravisht Iyer.
• Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.
• Spine. 2023 Dec 15; 48 (24): 170917161709-1716.

Study DesignRetrospective review of a prospectively maintained multisurgeon registry.ObjectiveTo study recovery kinetics and associated factors after cervical spine surgery.Summary Of Background DataFew 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.Materials And MethodsPatients who underwent either anterior cervical discectomy and fusion (ACDF) or cervical disk 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 discontinuing opioids by 30 days.ResultsSeventy 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 seven and six 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), and retired/not working (OR=0.69) were all associated with decreased odds of discontinuing opioids by 30 days.ConclusionsRecovery kinetics for ACDF and CDR are comparable. Most patients return to all activities after ACDF and CDR within 16 days. These findings serve as an important compass for preoperative counseling.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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