HealthDay News — X-rays taken during postoperative visits following cervical fusion surgery are rarely of value when history and exam are normal, according to a study published in the July issue of the Spine Journal.

Bennett D. Grimm, MD, from the Medical University of South Carolina in Charleston, and colleagues retrospectively reviewed the charts of 383 patients who underwent a cervical spine fusion (performed by one of seven surgeons) over a five-year period. The review included a total of 1,155 postoperative clinic visits (at least two visits with X-rays per patient). History and exam were graded as normal or abnormal, and plain radiographs were similarly graded.

The researchers found that very few patients with normal history and exam presentations (879 visits) had further action taken (0.57%), even in the presence of abnormal radiographs. Such actions included surgical revisions (two cases), prolongations of cervical collar immobilization (two cases), and one patient who underwent a flexion/extension radiographic evaluation followed by prolonged cervical collar immobilization.

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Abnormal X-rays were seen in 34 of the 276 visits with abnormal history and exam (12.3 percent), and 44% of clinic visits with abnormal history and exam and abnormal X-rays went on to revision.

“Routine postoperative radiographs after cervical spine fusion rarely appear to be of value when patients present with a normal history and exam and may expose patients to unnecessary diagnostic studies and expenses,” the researchers wrote.


  1. Grimm B et al. Spine J. 2013;13(7):764-769.