Table 2.

Descriptive report of included studies

Citation	Study design (n)	Years of age	Sex	Medical history	Pre-surgical pathology/ indication	Surgical history	Post-surgical history	Adverse events
Casagrande et al. [34]	Case report (1)	29	Male	Unknown cause of initial onset of neck and right shoulder pain with limited mobility due to lack of strength and pain Failed nonoperative therapy prior to CSS	Weakness in right arm abduction No biceps reflex MRI revealed right sided C4-C5 HNP compressing 5th nerve root	Right-sided anterior discectomy and interbody fusion with autologous bone from left iliac crest, plate placement between C4-C5	No surgical complications, discharged without pain Advised to wear Philadelphia cervical collar for 4-weeks 4-weeks post-operative x-rays revealed no abnormalities 10-weeks post-operative CT revealed no abnormalities and “good fusion” between C4-C5	Not reported
Cole et al. [49]	Case report (1)	70	Male	Presented to chiropractic clinic with chronic radiating LBP and cervical / thoracic junction pain Alcohol dependence in remission, PTSD and depression previously requiring hospitalization Lumbar laminectomy Long-term opioid therapy	Not Reported	C3-C7 fusion	Chronic cervical / thoracic junction pain Prior course of physical therapy, interventional spine procedures, long-term opioid therapy	Not Reported (Response to care following initial visit was reported to be without adverse effects)
Cooper and Golberg [35]	Case report (1)	43	Female	Extensive history of neck pain	Not reported	C6-C7 anterior fusion	Diagnosed with acquired cervical kyphosis, with associated cervicalgia, thoracic spine pain, lumbago	Not reported
Harrison et al. [36]	Case report (1)	62	Male	Not reported	C5-C6 instability, vertebral spondylosis, HNP	C5-C6 fusion using autologous iliac crest bone graft (13-years prior to intervention) 2nd operation consisting of anterior fusion with plate and autologous bone (12-years prior to intervention)	Patient continued to suffer from post-surgical axial and radicular symptoms Patient sought treatment for neck pain, numbness, tingling in right anterolateral forearm, and right arm weakness	Not reported
Murphy and Morris [37]	Case Report (1)	52	Male	Acetaminophen and oxycodone provided relief of neck pain ROS: recent onset of bilateral tinnitus; occasional chills and “fevers”; new onset balance problems; history of smoking and ETOH consumption; no regular exercise BP 155/90; Temperature 97.5 Fahrenheit (36.3 Celcius); respirations 25/minute; pulse rate 102 bpm	Not reported	C5-C6, C6-C7 anterior fusion (8 years prior to intervention) 2nd operation with insertion of instrumentation (6 years prior to intervention)	Recurrent episodes of neck pain Presented to ED 1 week prior to intervention for sharp pain in lower cervical area with referral to left shoulder; given a soft collar and released to follow up with PCP PCP referred patient for chiropractic evaluation	Mortality
Polkinghorn and Colloca [38]	Case report (1)	35	Female	15-year history of neck pain and cervical muscle spasm 6-month failed course of analgesics, NSAIDs, PT	Not reported	C3-C4 discectomy C5-C6 fusion 6-months following 1st surgery	Pain persisted after 2nd surgery for another 12-months Episodic cervical muscle spasms Condition exacerbated by cold/damp weather	Not reported
Salvatori et al. [39]	Case report (1)	46	Female	Osteoarthritis, HTN, LBP, neck pain with headache	1-year history of neck pain, headaches, frequent fatigue of upper quarter, intermittent pain referred to LUE	C5-C6, C6-C7 ACDF (8-weeks prior to intervention)	6-weeks immobilization of cervical spine with Aspen collar Improved pain referral to LUE No improvement in headache frequency or intensity, neck pain, upper quarter fatigue New onset of restricted cervical flexion and extension ROM, cervical muscle tightness and fatigue, intermittent referred pain to RUE	Not reported
Tibbles [42]	Case report (1)	28	Male	Initial onset of neck and upper back pain secondary to carrying daughter on shoulders; 24 h later experienced RUE numbness 4 1/2-month subsequent history of neck pain with radiation into RUE prior to CSS	C6–C7 right posterolateral HNP	C5–C6 discectomy	Persistent arm pain at discharge 6-weeks post-operative CT revealed C6-C7 HNP, surgical intervention completed at incorrect cervical (C5-C6) level Lower right-sided neck pain radiating into right trapezius muscle	Not reported
Bloink and Blum [43]	Case report (2)	30 52	Male Female	Ski related injury; unable to run/walk > 1/2 mile due to pain Use of dental device Not reported	Loss of sensation, function of right 3rd and 4th fingers; 5 months of physical therapy without improvement Significant neck pain with pain radiating into right arm and 2nd, 3rd fingers	C5-C6 disc replacement C5–C6, C6–C7 disc replacement	Symptoms improved for 3 months with recurrence of right neck pain, periscapular, and upper arm pain; experienced same symptoms on left side 2 x/week 3-months post-operative cervical MRI negative for pathology; attended physical therapy without improvement, trialed Neurontin Symptoms resolved initially with recurrence and progressive worsening in right arm; developed left arm to finger pain	Not Reported Not reported
Malone et al. [40]	Case series (2)	59 49	Male Male	Chronic neck pain Not reported	C7 right radiculopathy Not reported	C6-C7 allograft ACDF C4-C5 fusion	Not reported Fell at work, developed hand tingling and neck pain which he sought cervical SMT	Loss of function in hands followed by loss of ability to ambulate; decrease in UE strength; broad and spastic gait; diminished lower extremity proprioception; MRI revealed C5-C6 HNP causing marked spinal cord compression and abnormal signal in cord; underwent C6 surgical corpectomy and allograft strut- and plate-assisted fusion Worsening of right arm pain and weakness; diminished grip strength; 3 + DTRs; positive Hoffman bilaterally; radiography revealed HNP compressing cord at C5-C6; surgical intervention resulted
Peolsson et al. [32]	Randomized Clinical Trial (63)	Mean age 46	34 men, 29 women	Inclusion Criteria: 18–65 years of age Cervical radiculopathy for ≥ 8-weeks but < 5-years	MRI with confirmed nerve root compression due to CDD of 1 or 2 segmental levels	Group 1: ACDF included in intervention Group 2: No prior CSS	Not applicable	Not reported
Ren et al. [33]	Randomized Clinical Trial (86)	Mean age 54.2	29 men, 43 women	Inclusion Criteria: > 18 years of age Anxiety disorder ≥ 6 months prior to surgery  > 1-day post-operative following open reduction and internal fixation surgery	Not Reported	Group 1: Open reduction and internal fixation Group 2: Open reduction and internal fixation	Not applicable	Not reported

CSS cervical spine surgery, MRI magnetic resonance imaging, CT computed tomography, PTSD post-traumatic stress disorder, HNP herniated nucleus pulposus, ROS review of systems, ETOH alcohol, ED emergency department, PCP primary care provider, NSAIDs non-steroidal anti-inflammatory drugs, PT physical therapy, HTN hypertension, LBP low back pain, LUE left upper extremity, ACDF anterior cervical discectomy and fusion, ROM ranges of motion, RUE right upper extremity, SMT spinal manipulative therapy, CDD cervical degenerative disease