Post-Operative Physical Therapy Following Cervical Spine Surgery: Analysis of Patient-Reported Outcomes

Nathan A Lorentz; Matthew S Galetta; Michelle A Zabat; Tina Raman; Themistocles S Protopsaltis; Charla Fischer

doi:10.7759/cureus.40559

Post-Operative Physical Therapy Following Cervical Spine Surgery: Analysis of Patient-Reported Outcomes

Cureus. 2023 Jun 17;15(6):e40559. doi: 10.7759/cureus.40559. eCollection 2023 Jun.

Authors

Nathan A Lorentz¹, Matthew S Galetta¹, Michelle A Zabat¹, Tina Raman¹, Themistocles S Protopsaltis¹, Charla Fischer¹

Affiliation

¹ Orthopaedic Surgery, New York University (NYU) Grossman School of Medicine, New York, USA.

Abstract

Introduction Post-operative physical therapy (PT) following anterior cervical discectomy and fusion (ACDF) surgery is often performed to improve a patient's functional ability and reduce neck pain. However, current literature evaluating the benefits of post-operative PT using patient-reported outcomes (PROs) is limited and remains inconclusive. Here we compare post-operative improvement between patients who did and did not undergo formal PT after ACDF using Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Methods A retrospective observational study examining patients who underwent one- or two-level primary ACDF or cervical disc replacement (CDR) at an academic orthopedic hospital and who had PROMIS scores recorded pre-operatively and through two-year follow-up. Patients were stratified according to whether or not they attended formal postoperative PT. PROMIS scores and patient demographics were compared using the Mann-Whitney U test, Fisher's exact test, chi-square test of independence, and Student's t-test within and between cohorts. Results Two hundred and twenty patients were identified. Demographic differences between PT and no PT groups include age (PT 54.1 vs. no PT 49.5, p=0.005) and BMI (PT 28.1 vs. no PT 29.8, p=0.028). The only significant difference in post-operative PROMIS scores was in physical health scores at three months post-operatively (no PT 43.9 vs. PT 39.1, p=0.008). Physical health scores improved from baseline to one-year follow-up in both cohorts (PT +3.5, p=0.025; no PT +6.6, p=0.008). There were no significant differences when comparing improvements in physical health scores between groups at six months and one year. Conclusion In conclusion, there was no significance to support the benefits of post-operative PT as measured by PROMIS scores. No significant differences in PROMIS were observed between groups from pre-operative baseline scores to six-month and one-year follow-ups.

Keywords: anterior cervical discectomy fusion; cervical disc replacement; patient reported outcomes; physical therapy; promis scores.