Supine Cervical Traction After Anterior Cervical Diskectomy and Fusion: A Case Series

Background and Purpose: Cervical traction has been used for more than 50 years for the treatment of cervical disk pathology. However, there is a paucity of research in regard to the use of postoperative traction following surgery. The purpose of this case series is to describe evidence-based treatment using cervical traction for herniated nucleus pulposus (HNP) after anterior cervical discectomy and fusion (ACDF) in the cervical spine. Methods: This case series includes two patients with discogenic symptoms, including radicular symptoms and pathology in an area adjacent to an ACDF. In both cases, treatment was performed more than one year post ACDF and consisted of continuous cervical traction in supine using 15 to 17 pounds at a 12° or 20° angle for 10 to 20 minutes. Findings: After treatment with supine cervical traction, two patients with discogenic pathology and radicular symptoms had a significant reduction in symptoms and at least partial resolution of myopathy/radicular symptoms, including numbness and weakness. Clinical Relevance: Clinicians may be hesitant to use cervical traction after a patient has had ACDF surgery. This article offers examples of two cases in which patients status post ACDF improved with therapy, including the use of cervical traction. Conclusion: Caution should be taken when using cervical traction on the postoperative patient. However, in patients at least one year post ACDF, cervical traction may be a viable treatment for indicated pathology.