{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:33:48Z","timestamp":1792290828172,"version":"4.4.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9-10","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Military medical readiness plays a significant role in global military operations. While the severity of combat-related trauma is evident, musculoskeletal injuries (MSK\u2019s), are the largest medical threat to deployment readiness, and accounted for more than 60% of limited duty days in 2019. Across MSK\u2019s, the spine (lumbosacral: 30%; cervical: 22%; thoracic: 10%) accounts for 62% of MSKs. In the military population, there is a tremendous economic impact in training, retaining, and deploying a service member. Return-to-duty (RTD) rates and length of time for the treatment protocols for spine surgery vary significantly in published research. Research suggests RTD rates between 3-17 months following elective traditional open lumbar and cervical spine surgery, with a RTD rate of 64% within 1 year. When examining minimally invasive lumbar spine surgery (MIS), 100% of military personal had a RTD within 3 months. Research has yet to examine the impact of MIS of the cervical spine on the RTD rates of active-duty military.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The current study retrospectively examined surgical outcomes, return to duty, and patient-centric outcomes among 156 active duty or reserve military patients who underwent an outpatient minimally invasive (n\u2009=\u200979) cervical spine surgery or an open (n\u2009=\u200977) (Laminotomy\/Foraminotomy\/Decompression) for the treatment of cervical spinal stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant reductions in visual analog scale of 3.31 and neck disability index of 16.01 were observed from preoperative to postoperative time points. 77% of service members RTD in less than 1 month, 19% RTD in 1-2 months and 4% RTD between 2-3 months. There were insignificant differences reported in the open surgery group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussions<\/jats:title>\n                    <jats:p>MIS has been shown to reduce tissue trauma and patient complications. MIS procedures have resulted in reducing postoperative stress responses and improving the recovery process following surgery. In the active-duty military population this plays an important role in return to duty quickness. Our findings suggest that MIS procedures in an ambulatory surgery center on the cervical spine result in improved patient outcomes and reduced RTD time in active-duty military personnel.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag014","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T12:37:13Z","timestamp":1768048633000},"page":"e1887-e1894","source":"Crossref","is-referenced-by-count":1,"title":["Return to Duty Rates in Active-Duty Military: Comparing Minimally Invasive and Open Cervical Spine Surgery"],"prefix":"10.1093","volume":"191","author":[{"given":"Elder","family":"Granger","sequence":"first","affiliation":[{"name":"Capital Technology Information Services , Rockville, MD 20850,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Human Movement and High Performance Laboratory, School of Applied Sciences, University of Mississippi , MS 38677,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corbit","family":"Franks","sequence":"additional","affiliation":[{"name":"Human Movement and High Performance Laboratory, School of Applied Sciences, University of Mississippi , MS 38677,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Andre","sequence":"additional","affiliation":[{"name":"Human Movement and High Performance Laboratory, School of Applied Sciences, University of Mississippi , MS 38677,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8943-2327","authenticated-orcid":false,"given":"Chip","family":"Wade","sequence":"additional","affiliation":[{"name":"Human Movement and High Performance Laboratory, School of Applied Sciences, University of Mississippi , MS 38677,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reginald","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BioSpine Institute , Tampa, FL 33602,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"2026090403533223300_usag014-B1","doi-asserted-by":"publisher","first-page":"e619","DOI":"10.1093\/milmed\/usx104","article-title":"Return-to-duty rates following minimally invasive spine surgery performed on active duty military patients in an ambulatory surgery center","volume":"183","author":"Granger","year":"2018","journal-title":"Mil Med"},{"key":"2026090403533223300_usag014-B2","doi-asserted-by":"publisher","first-page":"572","DOI":"10.7205\/MILMED-D-15-00216","article-title":"Return to duty rates in active duty service members after elective surgery of the lumbar spine","volume":"181","author":"Lunsford","year":"2016","journal-title":"Mil Med"},{"key":"2026090403533223300_usag014-B3","doi-asserted-by":"publisher","first-page":"6","DOI":"10.29245\/2767-5130\/2020\/1.1104","article-title":"Biomechanics of military load carriage and resulting musculoskeletal injury: a review","volume":"1","author":"Fox","year":"2020","journal-title":"J Orthop Surg"},{"key":"2026090403533223300_usag014-B4","doi-asserted-by":"publisher","first-page":"e1461","DOI":"10.1093\/milmed\/usaa027","article-title":"Musculoskeletal injuries and United States army readiness part I: overview of injuries and their strategic impact","volume":"185","author":"Molloy","year":"2020","journal-title":"Mil Med"},{"key":"2026090403533223300_usag014-B5","doi-asserted-by":"publisher","first-page":"233","DOI":"10.3390\/diagnostics12020233","article-title":"Assessment from a biopsychosocial approach of flight-related neck pain in fighter pilots of Spanish air force. An observational study","volume":"12","author":"Espejo-Ant\u00fanez","year":"2022","journal-title":"Diagnostics"},{"key":"2026090403533223300_usag014-B6","doi-asserted-by":"publisher","first-page":"43","DOI":"10.3138\/jmvfh.3491","article-title":"Functional rehabilitation criteria required for a safe return to active duty in military personnel following a musculoskeletal injury: a scoping review","volume":"2","author":"Houghton","year":"2016","journal-title":"JMVH"},{"key":"2026090403533223300_usag014-B7","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3357\/asem.2602.2010","article-title":"Neck strength, position sense, and motion in military helicopter crew with and without neck pain","volume":"81","author":"Van den Oord","year":"2010","journal-title":"Aviat Space Environ Med"},{"key":"2026090403533223300_usag014-B8","first-page":"190","article-title":"Cervical spine stenosis measures in normal subjects","volume":"37","author":"Tierney","year":"2002","journal-title":"J Athl Train"},{"key":"2026090403533223300_usag014-B9","doi-asserted-by":"publisher","first-page":"376","DOI":"10.2106\/JBJS.F.00437","article-title":"Prevalence of cervical spine stenosis. Anatomic study in cadavers","volume":"89","author":"Lee","year":"2007","journal-title":"J Bone Joint Surg Am"},{"key":"2026090403533223300_usag014-B10","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1136\/injuryprev-2016-042234","article-title":"Developing predictive models for return to work using the military power, performance and prevention (MP3) musculoskeletal injury risk algorithm: a study protocol for an injury risk assessment program","volume":"24","author":"Rhon","year":"2018","journal-title":"Inj Prev"},{"key":"2026090403533223300_usag014-B11","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1377\/hlthaff.2013.1281","article-title":"Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up","volume":"33","author":"Munnich","year":"2014","journal-title":"Health Aff (Millwood)"},{"key":"2026090403533223300_usag014-B12","first-page":"1","article-title":"Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010","volume":"102","author":"Hall","year":"2017","journal-title":"Natl Health Stat Report"},{"key":"2026090403533223300_usag014-B13","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1097\/SLA.0000000000004201","article-title":"The increasing financial burden of outpatient elective surgery for the privately insured","volume":"272","author":"Billig","year":"2020","journal-title":"Ann Surg"},{"key":"2026090403533223300_usag014-B14","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usad330","article-title":"Return to duty in military service members following minimally invasive sacroiliac joint fusion","author":"Cognetti","year":"2023","journal-title":"Mil Med"},{"key":"2026090403533223300_usag014-B15","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.spinee.2011.10.010","article-title":"Spine-area pain in military personnel: a review of epidemiology, etiology, diagnosis, and treatment","volume":"12","author":"Cohen","year":"2012","journal-title":"Spine J"},{"key":"2026090403533223300_usag014-B16","year":"2011"},{"key":"2026090403533223300_usag014-B17","year":"2012"},{"key":"2026090403533223300_usag014-B18","author":"SECNAVINST 1850.4E"},{"key":"2026090403533223300_usag014-B19","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/s1529-9430(02)00566-1","article-title":"Cervical myelopathy. current diagnostic and treatment strategies","volume":"3","author":"Edwards","year":"2003","journal-title":"Spine J"},{"key":"2026090403533223300_usag014-B20","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1227\/01.NEU.0000057746.74779.55","article-title":"Laminectomy and posterior cervical plating for multilevel cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: effects on cervical alignment, spinal cord compression, and neurological outcome","volume":"52","author":"Houten","year":"2003","journal-title":"Neurosurgery"},{"key":"2026090403533223300_usag014-B21","doi-asserted-by":"publisher","first-page":"e1461","DOI":"10.1093\/milmed\/usaa027","article-title":"Musculoskeletal injuries and United States army readiness part I: overview of injuries and their strategic impact","volume":"185","author":"Molloy","year":"2020","journal-title":"Mil Med"},{"key":"2026090403533223300_usag014-B22","year":"2017"},{"key":"2026090403533223300_usag014-B23","year":"2017"},{"key":"2026090403533223300_usag014-B24","year":"2015"},{"key":"2026090403533223300_usag014-B25"},{"key":"2026090403533223300_usag014-B26","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.3171\/2018.9.FOCUS18380","article-title":"Return-to-active-duty rates after anterior cervical spine surgery in military pilots","volume":"45","author":"Miller","year":"2018","journal-title":"Neurosurg Focus"},{"key":"2026090403533223300_usag014-B27","doi-asserted-by":"publisher","first-page":"E18","DOI":"10.3171\/2010.1.FOCUS102","article-title":"Arthroplasty in the military: a preliminary experience with ProDisc-C and ProDisc-L","volume":"28","author":"Tumial\u00e1n","year":"2010","journal-title":"Neurosurg Focus"},{"key":"2026090403533223300_usag014-B28","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1093\/neuros\/nyy230","article-title":"Rate of return to military active duty after single and 2-Level anterior cervical discectomy and fusion: a 4-Year retrospective review","volume":"85","author":"Tumial\u00e1n","year":"2019","journal-title":"Neurosurgery"},{"key":"2026090403533223300_usag014-B29","doi-asserted-by":"publisher","first-page":"S75","DOI":"10.1016\/j.spinee.2023.06.057","article-title":"148. Cervical disc arthroplasty in the active-duty military population","volume":"23","author":"Patt","year":"2023","journal-title":"Spine J"},{"key":"2026090403533223300_usag014-B30","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.7205\/MILMED-D-14-00702","article-title":"The occupational impact of single-level cervical disc arthroplasty in an active-duty military population","volume":"180","author":"Cleveland","year":"2015","journal-title":"Mil Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/9-10\/e1887\/66901990\/usag014.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/9-10\/e1887\/66901990\/usag014.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:53:37Z","timestamp":1788508417000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/9-10\/e1887\/8483925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,14]]},"references-count":30,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2026,2,14]]},"published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag014","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,2,14]]}}}