PAIN+ CPN

Patients with cervical myelopathy, radiculopathy, and myeloradiculopathy often experience neck and arm pain, neurological impairments, and functional limitations that significantly affect their quality of life. Anterior cervical discectomy and fusion (ACDF) is the most commonly performed surgical procedure to address these conditions. In clinical practice, postoperative rehabilitation is widely recommended following ACDF to enhance recovery. However, the effectiveness of rehabilitation after ACDF remains inconclusive. This review aims to evaluate the efficacy of exercise-based rehabilitation programs after ACDF. We conducted a systematic search of articles concerning rehabilitation after ACDF, published through July 16, 2025. Our inclusion criteria focused on studies examining the effects of postoperative rehabilitation programs following ACDF. Our search identified 753 articles. After screening titles and abstracts, 729 articles that did not fulfill the inclusion criteria were excluded. The remaining 24 articles were further assessed for eligibility, and ultimately, 9 studies were included in this review. Early studies reported limited additional benefits from basic physiotherapy compared to usual postoperative care. However, recent studies employing structured, phase-based rehabilitation programs-including cervical muscle strengthening, postural correction, and home-based exercises-demonstrated significant improvements in pain, disability, and functional outcomes. Rehabilitation programs initiated within 6 weeks after surgery, particularly within the first week, were associated with improved recovery without increased complications. Additionally, nutritional support (eg, vitamin D supplementation) and patient-centered delivery approaches, such as home exercises combined with telephone support, further enhanced outcomes. Rehabilitation programs following ACDF have evolved to become increasingly systematic and comprehensive. Growing evidence supports the beneficial effects of rehabilitation after ACDF. Early structured rehabilitation programs appear to play a crucial role in reducing pain, improving functional outcomes, and enhancing postoperative recovery. Further research is required to better understand the effects of postoperative rehabilitation following ACDF.

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