As an exercise physiologist I have worked with a number of clients that have undergone cervical fusion surgery. Understanding and educating clients on the exercise rehabilitation process after surgery is important in helping to provide good recovery outcomes and realistic client expectations.
The cervical spine is a series of seven vertebrae that make up the neck, starting at the base of the skull and extending down to the thoracic spine. The cervical spine is delicate yet also very strong and flexible allowing movements in all directions. Surrounding the cervical vertebrae are a number of nerves, muscles, ligaments, tendons, intervertebral discs and blood vessels that assist with protecting the spinal cord, carrying out movement, facilitating blood flow to the brain and supporting the weight of the head which can weigh up to 5kg. Because of the complex and intricate structure of the neck there are many stresses that can be place on the cervical spine that make it susceptible to injury, here we are going to look at cervical fusion surgery and the importance of exercise rehabilitation.
Herniated discs or degenerative disc disease can occur as a result of trauma to the neck and wear and tear of the discs over time. If part of the disc moves out of its normal position it can cause pressure on the spinal cord or nerve roots, this can cause neurological symptoms which may include pain, weakness or numbness that radiates from the neck into one or both arms. Cervical fusion surgery is generally indicated if neurological symptoms persist longer that 12 weeks and don’t improve with exercise therapy, rest and medication. Cervical fusion surgery often involves entering through the front of the neck, removing the affected disc and replacing it with an artificial spacer or piece of bone.
Exercise rehabilitation following cervical fusion is an important part of the recovery process to address reduction in cervical range of motion, increased muscular tension, muscular weakness, altered movement patterns and to assist with pain management. Once the Surgeon has given clearance to begin exercise, an Accredited Exercise Physiologist can assist with prescribing an appropriate programme. Initially the exercise programme many include gentle neck mobility, isometric neck strengthening, postural education and small bouts of cardiovascular exercise such as treadmill walking or stationary cycling. When appropriate the exercise programme should progress to address neuromuscular control and posture through stabilisation and strengthening exercises of the neck, upper back, shoulders and trunk, to assist with returning to work, sport, hobbies and activities of daily living.
For more information contact an Accredited Exercise Physiologist at Absolute Balance today.
Lisa Wallbutton (BSR, MClinicalExPhysiol(Rehab))
Accredited Exercise Physiologist (AEP) (ESSAM)
Peolsson, A., & Kjelmann, G. (2007). Neck Muscle Endurance in Nonspecific Patients With Neck Pain and in Patients After Anterior Cervical Decompression and Fusion. Journal of Manipulative and Physiological Therapeutics, 343-350.