=====Neck mobility=====
A common question posed by patients undergoing [[cervical fusion]] pertains to the likelihood of perceiving a postoperative limitation in neck mobility. 

Patients who have had an ACDF for [[cervical radiculopathy]] will experience improved ROM 6 months postoperatively. In addition, patients can expect a decrease in pain, an improvement in neck function, and a decrease in headache frequency
((Landers MR, Addis KA, Longhurst JK, Vom Steeg BL, Puentedura EJ, Daubs MD.
Anterior cervical decompression and fusion on neck range of motion, pain, and
function: a prospective analysis. Spine J. 2013 Nov;13(11):1650-8. doi:
10.1016/j.spinee.2013.06.020. PubMed PMID: 24041918.
)).

The aim of a study was to assess the change in neck mobility after subaxial cervical fusion using an objective [[range of motion]] (ROM) measure and patient reported assessment.

Patients older than 18 years of age, undergoing first-time anterior or posterior subaxial cervical [[arthrodesis]] for a symptomatic spondylotic process (radiculopathy, cervical spondylotic myelopathy or primary neck pain) at a single center were eligible. Assessment included: 1) neck pain on a numeric rating scale; 2) four-directional objective neck mobility using the validated cervical ROM goniometer; and 3) a novel Mobility Assessment Scale (MAS) for patient perceived neck mobility. Subjects were dichotomized by number of levels fused (1-2 levels and ≥3 levels).

There were 25 patients with a mean of 2.7±1.5 levels fused. Neck pain was improved in both groups with mean change of -3.4 [95% CI -4.7,-2.1], p=0.004 for 1-2 levels and -3.5 [95% CI -5.4,-1.5], p=0.009 for ≥3 levels. MAS score improved significantly in group undergoing 1-2 level fusion (-1.8 [95% CI: -3.1,-0.4], p=0.016) but not in those with ≥3 levels fused. There was a significant positive correlation between MAS and neck pain in the 1-2 level fusion group (rs=0.667, p=0.012) but not in the ≥3 level group. Objective neck mobility did not changed significantly in either group.

Patient reported neck mobility was significantly improved following 1-2 level cervical fusion. This change correlated significantly with patient reported improvement in neck pain. No significant difference in reported neck mobility was found in those undergoing fusion of ≥3 levels
((Kasliwal MK, Witiw CD, Traynelis VC. Neck range of motion following cervical
spinal fusion: A comparison of patient-centered and objective assessments. Clin
Neurol Neurosurg. 2016 Oct 1;151:1-5. doi: 10.1016/j.clineuro.2016.09.020. PubMed
PMID: 27710812.
)).