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Return to Activity for On- and Off-Label Cervical Arthroplasty Patients: A Multicentered Expert Panel Recommendation
Jared D Ament1,2,3, Amir Vokshoor4,2, Jack Petros2
1Neurosurgery and Spine Group, Santa Monica, CA, USA jaredament@gmail.com.
International Journal of Spine Surgery
|December 10, 2025
Summary
This study establishes expert consensus on return-to-activity guidelines after cervical disc arthroplasty (CDA), offering faster recovery timelines than traditional fusion. Patients can resume most daily activities within two weeks post-CDA surgery.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Neurosurgery
Background:
- Artificial disc replacement (ADR) is an alternative to spinal fusion.
- Guidelines for safe return-to-activity (RTA) after ADR are needed.
- This study sought expert consensus on RTA after cervical disc arthroplasty.
Purpose of the Study:
- Establish expert-sourced consensus for safe RTA recommendations.
- Optimize patient recovery timelines following cervical disc arthroplasty.
- Provide evidence-based guidance for RTA after ADR.
Main Methods:
- Modified Delphi Method with 10 spine surgeons.
- Three rounds of surveys based on clinical cases and multiple-choice questions.
- Assessed expert agreement on 22 RTA recommendations.
Main Results:
- 86.4% agreement on 22 RTA recommendations.
- Unanimous agreement for returning to basic activities within 2 weeks.
- Strong consensus for earlier return to physical activity with ADR vs. fusion.
Conclusions:
- First consensus-based RTA recommendations for cervical disc arthroplasty.
- ADR patients generally recover faster than fusion patients.
- Individual factors should guide return to high-intensity activities.
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