Postoperative management following degenerative cervical spine surgery: Results from a survey conducted by the French Society of Spine Surgery - 12/03/25

Doi : 10.1016/j.otsr.2025.104218

Henri-Arthur Leroy ^a, Mourad Ould-Slimane ^b, François Lucas ^c, Jérôme Delambre ^d, Martin Dupuy ^e, Thais Dutra Vieira ^f, Marc Szadkowski ^f, Henri d’Astorg ^f,⁎
the members of the French Society of Spine Surgery
^a CHU Lille, Department of Neurosurgery, 59000 Lille, France
^b CHU Rouen, Department of Orthopedic Surgery, 76000 Rouen, France
^c Hôpital Privé Saint Martin, 14000 Caen, France
^d Hôpital Privé Geoffroy Saint Hilaire, 75005 Paris, France
^e Clinique de l’Union, Service de Neurochirurgie, 31240 Saint-Jean, France
^f Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, 69008 Lyon, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 12 March 2025

Abstract

Objective

To describe and evaluate postoperative care after degenerative cervical spine surgery among spine surgeons in France.

Hypothesis

The postoperative management after degenerative cervical spine surgery varies considerably depending on the team caring for the patient. Based on a national survey, we aimed at providing trends and guidelines regarding the following points: 1/ clinical follow-up and postoperative imaging, 2/ the place and role of bracing after surgery, 3/ driving recommendation and 4/ return to sports activities after such surgery.

Methods

Data were collected from spinal surgeons using a practice-based online questionnaire (SurveyMonkey Inc.). The survey comprised 15 questions on the current management following degenerative cervical spine surgery in France, especially single or multilevel anterior cervical discectomy fusion (ACDF). The surgeons were asked to answer several questions on 1) patient clinical follow-up, 2) postoperative imaging, 3) postoperative recommendation (e.g., bracing), and 4) time to return to work and sport practice.

Results

A total of 239 surgeons participated in the survey, including 158 (66%) neurosurgeons and 81 (34%) orthopedic surgeons. A total of 218 (96.9%) investigators proposed a face-to-face follow-up consultation within 6 weeks after surgery. A total of 210 (92%) practitioners asked for systematic cervical imaging at the first clinical follow-up. In the latter situation, cervical radiography was requested by 195 (85.2%) surgeons, and cervical CT scans were requested by 15 (6.6%) surgeons. A minority of surgeons recommended bracing after monosegmental cervical surgery (n = 99, 43%), except among orthopedic surgeons (n = 51 (63%), p < 0.0001). 38 (16.6%) surgeons advocated for early postoperative physiotherapy, and 130 (56.8%) for delayed physiotherapy. A prolonged time off work (>1 month) was recommended by 133 (57.8%) practitioners. 139 (62.9%) surgeons agreed on returning to sports without load or constraint during the first postoperative month, although orthopedic surgeons were more conservative than neurosurgeons (p = 0.0019). Conversely, return to sport with load (n = 171, 75.3%) or rotation (n = 219, 98%) was delayed for at least 1 month.

Conclusion

This nationwide study reflects the status of current postoperative management strategies after elective degenerative cervical spine surgery among the French spine community. Interestingly, the information provided to the patient may vary depending on the surgeon's specialty. Consensus-based recommendations are needed to homogenize practices.