Background Single congenital fusions are common anomalies, found most often at the C2–3 and C5–6 levels had moderate or severe degenerative changes in their cervical spines, or displayed signs of cervical instability. There is no motion at the level of congenital block vertebrae, as noted in flexion and extension radiographic analysis, resulting in excessive mobility and early degenerative changes at the adjacent unfused motion segments.

Objectives The aim of our single blind, randomized controlled study was to assess the efficacy of comprehensive home exercise program on neck pain and physical performance in patients with block vertebrae in lower cervical segments (C5-C6 and C6-C7).

Methods 36 patients with chronic neck pain and cervical block vertebrae were randomly assigned into exercise home group (G1, 19 patients) and second group (G2, 17 patients - noncompliant to exercise program). All patients were complete assessed (clinical, imagistic, functional). Kinetic program (first light positive exercise, next gradually strengthening exercises for the all cervical muscle exercise, one set of 10 repetitions each direction, twice a day and neck school exercises) was initiated in rehabilitation clinic. Duration of follow-up was 16 weeks after start of the intervention. At 4 and 16 weeks an independent physiotherapist unaware of the treatment allocation performed outcome assessments - pain (VAS) and Neck Disability Index (NDI) for functional status.

Results Comparing week 16 with baseline, pain improved significantly (p<0.05). Significant improvement in NDI scores for pain and functional status were found at week 4 and week 16 in the G1 compared to baseline. At 16 weeks, 16 (84.2%) patients mentioned their functional status as improved and only 3 (15.8%) as similar at baseline.

Conclusions The exercise program performed daily led to improvements in pain and physical measures. Optimal neck care in congenital cervical vertebra block includes pain-relieving exercises that also help restore neck posture, limitation of the neck movement and the muscular weakness. These techniques can help recover and provide good control against future symptoms (atrophy and neurological sensory loss, myelopathy).

Disclosure of Interest None declared