Dynamic Versus Conventional Retraction in Single-Level Anterior Cervical Discectomy and Fusion: A Prospective Comparative Study

Anterior cervical discectomy and fusion (ACDF) is the gold standard surgical treatment for symptomatic cervical myelopathy and radiculopathy. However, postoperative pain and functional recovery remain important clinical concerns. This study compares dynamic retraction with conventional Caspar pin retraction to determine whether technical modifications in the retraction technique improve patient outcomes. Patients undergoing ACDF were prospectively evaluated using the Neck Disability Index (NDI) and Visual Analog Scale (VAS) for pain assessment at baseline, postoperative day 1, postoperative day 5, 1 month, and 6 months. Outcomes were compared between the dynamic retraction group and the conventional Caspar pin retraction group. While the dynamic retraction group demonstrated superior early postoperative pain control, functional recovery was comparable between the groups. At 1 month, the dynamic retraction group achieved a VAS score of 0.58 ± 0.16 versus 1.1 ± 0.15 in the conventional group (p < 0.001). However, NDI scores were similar at 1 month (11.9 ± 1.8 vs. 12.1 ± 1.9, p = 0.62) and 6 months (8.4 ± 0.9 vs. 8.6 ± 1.0, p = 0.78). Pain scores converged by 6 months (0.50 ± 0.10 vs. 0.50 ± 0.11, p = 0.94). From preoperative baseline to 6 months, both groups achieved approximately 80% functional improvement in NDI scores. Dynamic retraction during ACDF provides superior early postoperative pain control compared with conventional Caspar pin retraction. However, both techniques produce equivalent functional recovery and long-term pain outcomes by 6 months, suggesting that either retraction technique may be employed based on surgeon preference and equipment availability.