Abstract
<title>Abstract</title> <p> <italic>Study Design:</italic> Retrospective Cohort Study <italic>Objective:</italic> This study aims to: 1) describe the natural course of post-operative PROM data for up to 2 years; 2) determine where PROMs become relatively stable in the postoperative time frame; and 3) investigate whether 1-year PROMs accurately reflect 2-year outcomes following anterior discectomy and fusion (ACDF). <italic>Summary of Background data:</italic> Patient-reported outcome measures (PROMs) are the gold standard for assessing success in cervical spine surgery. While many registries and studies require 2-year follow-up, it remains unclear if clinical improvement plateaus earlier. <italic>Methods:</italic> A retrospective analysis was conducted on 132 patients undergoing ACDF for degenerative disease from 2020 to 2023. PROMs, including the Short Form-12 Physical and Mental Component Summaries (PCS, MCS), Visual Analog Scale (VAS) for neck and arm pain, and the modified Japanese Orthopaedic Association (mJOA) scale, were collected at baseline, 3, 6, and 24 months postoperatively. Post hoc comparisons were performed between 1 year and 2 year intervals to determine stability of long-term outcomes, with significance established at <italic>P</italic> < 0.05. <italic>Results:</italic> Significant improvements from baseline were observed across all PROMs starting at 3 months ( <italic>P</italic> < 0.001) besides MCS which remained relatively stable. All PROMs displayed no significant differences starting from 3 months to 24 months ( <italic>P</italic> > 0.05). Between 12-month and 24-month intervals, there were no statistically significant differences in PCS ( <italic>P</italic> = 0.996), MCS ( <italic>P</italic> = 0.994), VAS Neck ( <italic>P</italic> = 0.843), VAS Arm ( <italic>P</italic> = 0.956), or mJOA ( <italic>P</italic> = 0.964). <italic>Conclusions:</italic> Patient reported recovery following ACDF stabilizes by one year postoperatively with the largest change in scores occurring from preoperative to 3 month time points. These findings suggest that 1-year PROMs are a reliable proxy for 2-year outcomes, potentially allowing for streamlined follow-up protocols and reduced institutional questionnaire burden. </p>