Safety and feasibility of an early telephone-supported home exercise program after anterior cervical discectomy and fusion: a case series.
Rogelio A Coronado, Clinton J Devin, Jacquelyn S Pennings and 5 others
PMID 31663795WHAT IT FOUND
Eight patients undergoing anterior cervical discectomy and fusion completed an early, telephone-supported home exercise program.
No signs of non-union were found at six months. Patients rated the program helpful, and most showed clinically meaningful reductions in pain and disability, though objective physical activity gains were limited.
Key findings
01No signs of non-union were present on radiographic assessment at six months, suggesting the early exercise program was safe.
02Seven of eight patients reported clinically relevant reductions in neck and arm pain intensity at six weeks, and six of eight reported clinically relevant reductions in disability.
03While all patients self-reported a meaningful increase in physical activity, only two or three patients showed objective increases in steps per day at follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a case series with no control group, so it is impossible to attribute observed improvements to the exercise program rather than the surgery itself or natural recovery. The sample size was very small (eight patients), limiting generalizability. Adherence was measured by self-report diaries, which may overestimate actual exercise performance. Safety assessment relied primarily on static radiographs for most patients, with dynamic flexion-extension views only available for three patients, which may not fully capture segmental instability. The study did not measure range of motion or muscle strength, so localized tissue effects of the exercise were not assessed. Follow-up was limited to six months, leaving long-term outcomes and fusion stability unknown.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the clinical improvements as evidence that the home exercise program caused the recovery. Since all patients also underwent ACDF surgery, the improvements in pain and disability could be due to the surgery itself or natural postoperative healing, rather than the specific exercises or telephone support.