Cervical Spondylosis Developing Post Anterior Cervical Discectomy and Fusion– A Case Study

Background Cervical spondylosis, a degenerative condition with > 85% prevalence in those over 60, often requires anterior cervical discectomy and fusion (ACDF) for symptomatic C5-C6 herniations refractory to conservative care. Postoperative rehabilitation gaps, however, lead to myofascial tightness in trapezius, rhomboids, levator scapulae, and cervical muscles, causing bilateral shoulder radicular pain, restricted range of motion (ROM), sleep disruption, low back pain from kinetic chain deficits, and functional limitations in standing or household tasks. Case Presentation A 67-year-old active woman underwent ACDF at C5-C6 in March 2025 following traumatic strangulation-induced disc herniation with cord compression and multilevel prolapses (C3-C4, C4-C5). Without formal rehab for one year, she presented in February 2026 with NPRS 8/10 bilateral shoulder pain radiating to hands, hypertonicity eliciting pain on light palpation, minimal neck/shoulder ROM, rapid leg fatigue, and inability to stand for chores. Intervention A 4-week program applied muscle energy technique (MET) using post-isometric reciprocal inhibition to lengthen hypertonic upper trapezius while activating antagonists (lower trapezius, serratus anterior). Trapezius inhibition via sustained isometric holds and manual pressure addressed hypersensitivity, complemented by gentle active-assisted ROM exercises, core stabilization, posture training, and progressive strengthening. Outcomes NPRS dropped to 2/10; cervical lateral flexion and shoulder flexion reached moderate ROM; low back pain and leg fatigue resolved; full household task tolerance and prolonged standing achieved. Conclusion MET and trapezius inhibition rapidly reversed post-ACDF deconditioning despite delayed presentation, restoring function in elderly patients. Early referral prevents adjacent segment disease and secondary deficits; controlled trials in post-ACDF cohorts are needed.