I figured it was just "the next thing" . Do you believe that my problem comes from the C3/C4 area? Loss !he read all of my issue and details and his replies really helped me in decidingi am now confident about my decision and i now totally understand the procedure thanks to the in-depth information providedthank you ever so much ! Patel MR, Jacob KC, Parsons AW, Vanjani NN, Prabhu MC, Pawlowski H, Singh K. Int J Spine Surg. Despite overall group improvements, some individuals report remaining, or recurrent, disability and pain at short [9] and long-term [5, 6, 10,11,12] after ACDF. Long-term follow-up of one hundred and twenty-two patients. Level of evidence: Pain and disability were correlated with lower self-efficacy and quality of life. Swedish Medical Journal [Internet]., Herbert RD, Kasza J, Bo K. Analysis of randomised trials with long-term follow-up. Anna Hermansen. No previous studies have investigated differences in pain and disability between the Cloward Procedure (CP) and a fusion cage more than 20 years after surgery. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. https://doi.org/10.1186/s12891-023-06503-w, DOI: https://doi.org/10.1186/s12891-023-06503-w. Pain. There was a significant main effect in disability over time F(2,80)=9.30, p < .001, Cohens d=0.96. Follow-ups 20 years after surgery are extremely rare [5, 6, 12], and often lack assessments of disability and psychosocial factors. An individual who is not interested in more surgery may consider alternative treatments for their pain. Hermansen A, Peolsson A, Kammerlind AS, Hjelm K. Womens experiences of daily life after anterior cervical decompression and fusion surgery: a qualitative interview study. Blind Pain and disability improved substantially over time, irrespective of surgical technique. An official website of the United States government. Patients with pseudarthrosis detected 1 year postoperatively may be observed without any intervention because approximately 70% of them will eventually fuse by the 2-year point. Forty-five (VAS) and 42 (NDI) individuals completed ratings at all three time-points and were included in the ANOVA. Brain J Neurol 1994; 117 (pt 2):325335. 1 year post op ACDF have I fused or not and what to surmise of this.. 1 year post op ACDF have I fused or not? Smile Im nervous and afraid to have another surgery since the first one didnt help but Im not sure what else I can do. Pain. The Cloward procedure was performed according to standard techniques using bicortical iliac autograft to fill the empty disc space after removal of the disc and osteophytes [2]. Overview Anterior cervical diskectomy and fusion (ACDF) surgery is done to remove damaged disk or bone spurs in your neck. Cha EDK, Lynch CP, Ahn J, Patel MR, Jacob KC, Geoghegan CE, Prabhu MC, Vanjani NN, Pawlowski H, Singh K. Int J Spine Surg. Minimally invasive posterior cervical foraminotomy versus anterior cervical discectomy and fusion for cervical radiculopathy: a meta-analysis. Interspace otherwise negative. Three months after undergoing C5-T1 anterior cervical discectomy and fusion (ACDF), an active 60-year-old man from Florida began to experience recurrent neck and left shoulder pain. This procedure has many different methods, including discectomy, bone grafts, metal cages, among others. Higher rates compared to earlier follow-ups may be due to an over-representation of satisfied individuals choosing to participate in the present study. However, no studies have evaluated this more than 20 years after surgery. Jacobson GP, Newman CW. 2022 Dec;16(6):983-990. doi: 10.14444/8334. By using this website, you agree to our Clinical improvement after surgery for degenerative cervical myelopathy; A comparison of Patient-Reported Outcome Measures during 12-month follow-up. The graft used has not fully incorporated but has partially incorporated. 3. Fifty individuals (mean age 69, 60% women, 55% CIFC) completed questionnaires. PubMed Coin Background Axial neck pain is one of the complications of posterior cervical surgeries such as laminoplasty. CELLAXYS does not offer Stem Cell Therapy as a cure for any medical condition. PubMedGoogle Scholar. Anterior cervical discectomy surgery (ACDF) is a procedure to reduce neck and back pain caused by disc problems. Cloward RB. Im a middle school teacher. Posterior foraminotomies are generally more uncomfortable in the first two weeks but have about the same amount of total time for recovery (6 weeks). I had the same cervical fusions as you did 7", "I wanted to respond to the above text for the pain after surgery of cervical fusion". A systematic review of a variety of surgical techniques showed an overall success rate of approximately 80% [1], and long-term follow-ups show success rates of 7888% [4,5,6,7,8]. 2022 Oct;16(5):615-624. doi: 10.31616/asj.2021.0424. Director of Regenerative Interventional Spine Medicine AP was involved in planning the study, collecting and interpreting data and was a major contributor in writing the manuscript. Gee, I had C2 to T2 fused and have shoulder pain as well now. Epub 2022 Oct 17. 1996;37:5372. Spine (Phila Pa 1976). Available from: https://login.e.bibl.liu.se/login?url=http://link.springer.com/https://doi.org/10.1007/978-94-007-7596-1. Gore DR, Sepic SB. During the procedure and the healing process, the structure is particularly vulnerable. This brings to my question- My surgery December 2015 and my 1 year post Op December 2016 or Jan 2017- where X-rays indicated slow fusing, the doc was concerned with c4/5 level not fusing as well as the c6/7 so he ordered a CT. So how will that affect your quality of life? The explanation and descriptions are easy to follow and so helpful in understanding the a variety of conditions covered.Thank you Dr Corenmen for providing such a valuable directory of information. Is so, what help you deal with them? Patients faced with chronic pain may seek these treatments as an alternative to surgery, often with promising results. 2003;12:96374. What is the role of dynamic cervical spine radiographs in predicting pseudarthrosis revision following anterior cervical discectomy and fusion? 2014;37:8796. 2016;48:3528. Truelove sharing sensitive information, make sure youre on a federal Three months after undergoing C5-T1 anterior cervical discectomy and fusion (ACDF), an active 60-year-old man from Florida began to experience recurrent neck and left shoulder pain. i was so confused and lost about which procedure i should treat my back pain with.Dr.Corenman is just so kind to make time from his schedule to help me :')! He doesnt see movement in the flex and extension x rays. I am so sorry. Despite the risks involved, many patients see positive results after a lengthy recovery period. How-to Something to consider about neck fusion surgery is that it may not produce the intended results. A 30mm reduction in VAS and a change score of 20% units in the NDI were used as cut-offs to determine clinically relevant improvements (CRI) in pain intensity [25] and disability [26]. However, the majority of participants reported residual disability not to a negligible extent. Treatment for neck pain can come in many forms because there are so many that arise in the area. I", "Good evening @ljbsgausa, welcome to Connect. Ill speak to my pain med doc immediately. Does everyone think they are related? Study design: I still have right shoulder stiffness and pain in my upper neck and trap area. Pain and disability were correlated to lower self-efficacy and quality of life. This site contains no medical advice. Google Scholar. Study design: One-hundred and three consecutive patients were randomized to, and 95 were treated (19951998) with either the CIFC [2] or the Cloward Procedure [15]. Presence of pseudarthrosis was evaluated 1 year postoperatively and then the nonunion segments were re-evaluated 2 years postoperatively. Memory CAS Int J Spine Surg. I tried them all, tens unit, 2 years physical therapy land and pool. Pain and disability improved substantially over time, irrespective of surgical technique. This pain is really wearing on me. Neck pain after surgery..5 years later ? Data was collected through self-reported questionnaires that were distributed via the post. I had neck surgery in 2010 at c5/6 level and all was well 100% fused etc without further issue. Assessment of chronic pain. Go to the Spine Health Support Group. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. An administrator at the neurosurgical clinic identified individuals from the original study [2] and still available for participation, and questionnaires were sent via the post. You probably will not fuse at the levels above and below this C5-6 level as one year is generally enough time to determine fusion status. Brooks R. EuroQol: the current state of play. J Bone Joint Surg Am. Fourteen individuals did not complete the questionnaire. The C5-6 interspace demonstrates mild central canal, mild left neural foraminal, and moderate to marked right neural foraminal narrowing secondary to significant spur involving the right uncovertebral joint. Biomechanical Study of Cervical Endplate Removal on Subsidence and Migration in Multilevel Anterior Cervical Discectomy and Fusion. After many docs I have a wonderful treatment plan. 2006;121:1517. What is confusing is that I expect this MRI to be performed after your ACDF but the radiologist does not mention anything about the surgery Not necessarily unexpected as I have seen some radiologists either miss the surgery or be lazy. Leaves The goal of the surgery is to alleviate pain, tingling, and numbness associated with . Adv Physiotherapy. Famous I take muscle relaxers, Tylenol and advil with little relief. 2005;7:96107. I now have the feeling that I need to constantly clear my throat, horrible taste in my mouth and still have extreme pain in back of neck in area where surgery was done. I highly recommend Dr. Corenman and the Steadman Clinic. I was trying to manage it but nothing worked. Cervical fusion is generally considered safe, however, it is major surgery. May 2015 The authors declare no competing interests. No funding was obtained for this long-term follow-up. A few participants had however had additional surgeries which might have addressed such changes and thus altered the group means to the better. Sign up to read more articles like this delivered straight to your inbox! February 2015 I have heard that posterior surgeries are very painful and you can miss a lot of work. Self-reported population health: an international perspective based on EQ-5D [Bibliographies Online Non-fiction Electronic document]: Springer; 2014. 9/11 Thank you so much!! Summary of background data: Pseudarthrosis is a frequent complication of ACDF and causes unsatisfactory results. Methods This prospective study included 118 patients (90 men and 28 women; average age: 66.9 (32-86) years) with cervical myelopathy who . Methods: Neck-related disability was assessed with the Neck disability index (NDI) score (0=no disability, 100=complete disability). If you have little to no pain and the X-rays (flexion/extension) dont show significant motion, you do not need to worry about these levels currently. i was so confused and lost about which procedure i should treat my back pain with.Dr.Corenman is just so kind to make time from his schedule to help me :')! This website is the stand out source for me. Learn more about the procedure below. I had just had a reverse shoulder replacement before the cervical surgery. 1983;16:87101. Interspace otherwise negative. Symptoms Some amount of neck discomfort, soreness, tenderness, and swelling is normal after a spinal fusion procedure. Awakening Summary of background data: August 2015 Follow-ups more than 20 years after neck surgery are extremely rare. World Neurosurg. RH was involved in planning the study, interpreting data and was a major contributor in writing the manuscript. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. A p-value of < .05 was considered statistically significant. Spine (Phila Pa 1976). PubMed Central The purpose of this study was to describe pain and functioning more than 20 years after anterior cervical decompression and fusion surgery, and to compare outcomes between the Cloward Procedure and the carbon fiber fusion cage (CIFC). Methods: Demographic and cross-sectional descriptive data was analyzed using parametric or non-parametric tests depending on the measure and normality of data. Mean dizziness ratings were low; however balance problems and disability due to dizziness were higher, which is in line with 10-year data [30]. PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. Cervical disc herniation and cervical spondylosis surgically treated by Cloward procedure: a 10-year-minimum follow-up study. I am not as strong as I once was. What has been recommended and how can we help? Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Mills ES, Mayfield CK, Shelby T, Ton AT, Hah RJ, Alluri RK. Disclaimer. I have to take muscle relaxer to be able to sleep at night. 2018;41:47382. All participants received written information and provided written informed consent to participate prior to analyzing data. Escape Hermansen A, Peolsson A, Hedlund R, Kammerlind AS. Two hundred thirty-five patients met inclusion criteria. Both pain and disability remained improved during this 20-year period. Before I had scar tissue in my neck and could hardly swallow, so another dr stretched it last year and it helped some but it is tightening up again. So c5/6 should never even be a topic as far as I was concerned it fused in 2011 and that had gone unchanged by all accounts.. Unauthorized use of these marks is strictly prohibited. Todays cages may allow bony ingrowth or be fixed by integrated screws, avoiding the need of plates. Some pain is likely after discharge from the hospital. Short Story I have very little discomfort in my neck as long as I do yoga stretches every morning and use the cervical collar. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. FOIA Neck pain is a common occurrence. Youth. Differences between surgical groups and across three time periods (baseline, 10- and 20-year follow-ups) was analyzed using a 32 mixed design analysis of variance (ANOVA). Ramblings, wonderings and such from my mind. Hang in there. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Hilibrand AS, Carlson GD, Palumbo MA, et al. Has anyone had this same surgery and dealt with any of these post-op issues? Reporter Pseudarthrosis is a frequent complication of ACDF and causes unsatisfactory results. A population-based study from Rochester, Minnesota, 1976 through 1990. Google Scholar. 2018 Jan 15;43(2):97-104. doi: 10.1097/BRS.0000000000002271. Federal government websites often end in .gov or .mil. 2022 Dec;45(6):3609-3618. doi: 10.1007/s10143-022-01882-5. A 20-24-year follow-up of a randomized controlled trial comparing self-reported outcomes of neck pain and disability after CP and a CIFC [2]. The https:// ensures that you are connecting to the Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Many patients have been observed with conditions such as bone spurs, which can cause a lot of damage and discomfort, but report no symptoms. A visual analogue scale for neck/arm pain and the Neck Disability Index were analyzed preoperatively and at 1 and 2 years postoperatively. Along with the neck pain, I am also having shoulder pain. Neck fusion surgery also called Anterior Cervical Fusion and Discectomy (ACDF), is the process of fusing two vertebrae in an attempt to stabilize the spine or remove a disc. I had horrible neck and upper trapezius pain for about 1.5 years. Spine (Phila Pa 1976). MeSH Everyone is different but there is a plan for you! Methods: Eighty-nine patients with a minimum 2-year follow-up were included. Neurosurgeon employs minimally invasive approach to alleviate pain You should have had the spur eliminated or at least significantly reduced with surgery. Magnetic resonance imaging (MRI) revealed a moderate disc herniation at the C4-C5 level, and flexion-extension cervical spine plain films showed hypermobility at the same level. The patient traveled to Duke to consult with Michael Haglund, MD, PhD, a neurosurgeon who specializes in cervical spine disease. See Table1 for inclusion and exclusion criteria. Epub 2016 Feb 19. Only 53% of the original participants were included in this 20-year follow-up. Mean time since surgery was 22.4 years (range 20,524). Provided by the Springer Nature SharedIt content-sharing initiative. Bethesda, MD 20894, Web Policies However nobody can tell me if I fused yet at the C5/C6 levels. The higher rate of participants scoring good to excellent global outcome compared to improvements in pain and NDI might be a result of the global perceived effect measures (such as the modified Odom) being influenced by a variety of factors and not only success from a perspective of the domains included in pain ratings and the NDI [29]. Faldini C, Leonetti D, Nanni M, Di Martino A, Denaro L, Denaro V, et al. Responsiveness of the Neck Disability Index in patients with mechanical neck disorders. Out of the original sample 64 eligible participants received an invitation to participate. 2009;9:8028. Worse health was strongly correlated to neck pain and disability in the present study. This might be due to participants with pain who continue to live their lives in a somewhat limited way, thus reducing the mechanical strain on the neck, but with a consequent impact on daily life. Article UCLA Alumni. Greenhouse-Geisser correction was used when the sphericity assumption was not met. Physical Medicine and Rehabilitation 20 years experience. Spine (Phila Pa 1976). Would you like email updates of new search results? And if it didnt fuse the first time, whats your guarantee that it fuses the next time?. Long-term clinical outcomes following 3- and 4-level anterior cervical discectomy and fusion. Similar rather large differences in the CIFC group based on early fusion status were noted as early as the 2-year follow-up [2]. This all became one of those nightmares from a fall down the mountain. September 2015 I also have some pain that shoots up towards my right ear. Carlsson AM. Manual therapy for cervicogenic dizziness: long-term outcomes of a randomised trial. Abstract Study design: Retrospective cohort study. March 2015 The .gov means its official. I started having motor weakness in my arm which is when my neuro said it was time for surgery. 2023 Apr;17(2):215-221. doi: 10.14444/8410. Weakness. 2002;4:11124. If not an ADR candidate and C4-5 is not too degenerative, then an ACDF would be acceptable. FOIA What we can do is help you research your medical status and ask others to share their treatments and medical care with you. Objective: Burkhardt BW, Brielmaier M, Schwerdtfeger K, Oertel JM. The C5-6 interspace demonstrates mild central canal, mild left neural foraminal, and moderate to marked right neural foraminal narrowing secondary to significant spur involving the right uncovertebral joint. Dysphagia May Attenuate Improvements in Postoperative Outcomes Following Anterior Cervical Discectomy and Fusion. Only eight patients showed persistent nonunion at 2 years: 3 of 15 patients after single-level surgery, 3 of 9 after two-level surgery, and 2 of 5 after three-level surgery. A prospective randomized comparison between the cloward procedure and a carbon fiber cage in the cervical spine: a clinical and radiologic study. Repair of symptomatic pseudarthrosis of anterior cervical fusion: posterior versus anterior repair. J Bone Joint Surg Am 1999; 81:519528. 2010;35:3643. Results from the present study based on how much the participants improved in self-reported disability and pain show significant differences in NDI based on fusion status, but only when adjusting for baseline values. Radhakrishnan K, Litchy WJ, OFallon WM, et al. 2004;111:24552. The CT radiology report makes no sense to me at all and Im so overwhelmed having been thru so much Im terrified at my follow up in a couple of weeks, if I hadnt fused and what will come next.. Heres what the radiology report says: Evidence of ACDF from C4 to C7 without evidence of hardware failure or loosening. I had surgery because I continued to fall, was losing function of 1 hand, foot and could no longer feel temperature. 3. Eur Spine J. Ensuring a proper diagnosis is a good step to take, but sometimes conventional methods fail to provide relief. Google Scholar. 2017 Oct;106:724-735. doi: 10.1016/j.wneu.2017.06.051. Please enable it to take advantage of the complete set of features! Spearmans rho was used to evaluate the relationship between pain and disability, and psychosocial factors. Sex There are many reasons why patients may experience abnormal pain in the neck after surgery. Poker 2014;23:88897. Disability after Anterior Decompression and Fusion for Cervical Disc Disease. Clinically relevant improvements were defined as 30mm decrease in pain and a decrease in disability of 20 percentage units. If you have significant ongoing symptoms, you probably need a revision surgery. Eighty-eight per cent of participants experienced improvements or full recovery, 71% (pain) and 41% (NDI) had clinically relevant improvements. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. Results: The results from this study do not support the idea that fusion technique affects long-term outcome of ACDF. Before Effect sizes were considered small if Cohens d was >0.2, intermediate if>0.5, and large if>0.8. Ill keep you posted. Hermansen, A., Hedlund, R., Zsigmond, P. et al. All Rights Reserved | Website by WP Flare, Anterior Cervical Fusion and Discectomy (ACDF). Why do I still have narrowing and a significant bone spur at the C5/C6. Follow Posted 5 years ago, 3 users are following. October 2014 Effect of various kinds of cervical spinal surgery on clinical outcomes: a systematic review and meta-analysis. Good evening sir. Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linkping University, Building 511, Entrance 76, Level 15, Linkping, SE-581 83, Sweden, Aleris Ortopedi, Nacka Specialistsjukhus, Stockholm, Sweden, Department of Biomedical and Clinical Sciences, Linkping University, Linkping, Sweden and Department of Neurosurgery, Region stergtland, Linkping, Sweden, Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linkping, Sweden; Occupational and Environmental Medicine Centre and Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linkping University, Linkping, Sweden, You can also search for this author in Interspace otherwise negative. This greater improvement remained following regression analysis (P = 0.025). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Secondary outcomes were frequency and intensity of neck and arm pain, headache, dizziness, self-efficacy, health related quality of life or global outcome. Most participants were also retired from work, possibly reducing the strain on the neck, and subsequently their pain ratings. I dont want to get out right now due to virus as I have other health issues. I cant play catch or shoot a basketball with my son because that motion causes great pain. Unable to load your collection due to an error, Unable to load your delegates due to an error. CAS Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This follow-up did not include radiographic evaluation, which would have allowed an assessment of the possible impact of degenerative changes. Im only 40 years old and I want to be able to golf, coach and be active again and I hoped the first surgery would have led to that but it seemed to make it worse. It's been almost a year since my surgery. Fire In conclusion, the results of this study do not support the idea that type of fusion technique affects the long-term outcome of ACDF. Conclusion: Clipboard, Search History, and several other advanced features are temporarily unavailable. government site. Bookshelf Summer Accessibility I highly recommend Dr. Corenman and the Steadman Clinic. volume24, Articlenumber:406 (2023) Using a patients own regenerative cells and the bodys healing components, doctors can pinpoint the location of an injury and transplant a concentrated solution of these cells to boost the natural healing process. Bohlman HH, Emery SE, Goodfellow DB, et al. neck pain If your C4-5 disc is significantly degenerative, it might have to be included as a fusion or even artificial disc. Epidemiology of cervical radiculopathy. These main results are in line with previous follow-ups at 2 years [2], 6 years [27], and 10 years [8] years after surgery. Are Cervical Disc Arthroplasty Medicare Reimbursement Trends Sustainable? Management of Symptomatic Cervical Spine Pseudarthrosis: A Suggested Algorithm for Surgical Planning. It may be the case that an injury was missed during the initial diagnosis, which may lead to a completely different treatment plan. PubMed Good evening @ljbsgausa, welcome to Connect. ACDF patients have a 10-15% risk of needing another neck surgery on an adjacent segment in the next 10-15 years. This might be from the front again (a repeat ACDF with your own bone) or from the back (a posterior fusion) depending upon the symptoms and findings on X-ray and CT scan. (partial anything makes no sense- I was and have been fused there)? Pain and NDI were correlated with lower self-efficacy and quality of life. The individuals beliefs in their own ability to perform their daily activities despite pain was assessed with the Swedish version of the self-efficacy scale (0=not at all confident to 200=very confident) [23]. 2023 Feb;23(2):238-246. doi: 10.1016/j.spinee.2022.10.005. Headache and dizziness may be caused by impairments of the cervical spine and has previously been reported in patients after ACDF. Early revision could, however, be considered if the pseudarthrosis is associated with considerable neck pain after multilevel ACDF. After all, one or more of your neck's mobile joints would be fused solid and cease to move. This site needs JavaScript to work properly. Pain. Viewing 2 posts - 1 through 2 (of 2 total). Hermansen A, Hedlund R, Vavruch L, Peolsson A. Article Patients of both sexes and age more than 18 years who underwent ACDF (single/multiple levels) were included and the medical record was checked for whether they had persistent shoulder pain following ACDF. Spine (Phila Pa 1976) 1992; 17 (10 suppl):S427S430. 1998-2023 Mayo Foundation for Medical Education and Research. 2018;18:48. Location: 5741 S Fort Apache Rd suite 100, Las Vegas, NV 89148, USA, 2023 Cellaxys. After removal of the collar, and if needed, patients were referred to a physiotherapist in primary healthcare. Albanese V, Certo F, Visocchi M, Barbagallo GMV. Postoperatively, all cohorts experienced significant (P < 0.001) reduction in VAS neck pain, (VAS neck; R group: -2.9, M: -2.5, MR: -2.5) with no significant differences between groups. These therapies have shown promising results for many conditions including spine therapies. Cookies policy. Mean disability score was 22.6 (SD 18.2) (Table3). A more than 20-year follow-up of pain and disability after anterior cervical decompression and fusion surgery for degenerative disc disease and comparisons between two surgical techniques, https://doi.org/10.1186/s12891-023-06503-w, https://login.e.bibl.liu.se/login?url=http://link.springer.com/, https://doi.org/10.1007/978-94-007-7596-1, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmcmusculoskeletaldisorders@biomedcentral.com.
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