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STUDY DESIGN
Prospective, observational study.

OBJECTIVE
The aim of this study was to collect objective and especially subjective data on changes in cervical spine mobility after single-level anterior cervical decompression and fusion (ACDF) and to investigate the impact on quality of life and activities of daily living (ADLs).

SUMMARY OF BACKGROUND DATA
Although there are several studies dealing with the objective change in mobility after single-level ACDF, there are few data on how spondylodesis of a motion segment affects subjective restriction of cervical spine mobility.

METHODS
Patients undergoing first-time, single-level ACDF for a symptomatic spondylotic process were eligible. Data were collected before surgery, at 3-month, and 1-year follow-up. Patients were assessed via clinical scores (pain intensity, Short-Form 8 [SF-8], among others) and asked for impairment in ADLs due to restriction of cervical spine mobility. The subjective restriction was acquired by a five-step patient-reported score. The range of motion was measured by the CROM device.

RESULTS
Data of 97 patients could be evaluated. For pain scores and SF-8 there were significant improvements 3 months and 1 year after surgery (P < 0.001). The impairment for most ADLs improved 3 months after surgery and further after 1 year. The subjective restriction showed a significant improvement in general and for all single directions 1 year after surgery. In the objective measurements, a significantly higher total rotation could be found 1 year after surgery compared to preoperatively (101.6° ± 21.2 vs. 93.9° ± 23.4; P = 0.002). There were no significant differences in total flexion-extension and lateral flexion. Increasing age was a significant predictor for objective and subjective restriction.

CONCLUSION
The concern of many patients of being severely restricted in their cervical spine mobility after single-level ACDF can be denied. Objectively, the rotation even showed a significant improvement. Regarding the subjective restriction, which is more important for the patients, we found a significant improvement in general and for all directions of movement after surgery.Level of Evidence: 3.