Our Summary

The research paper talks about a common surgery performed on the neck called Anterior cervical discectomy and fusion (ACDF). The number of these surgeries has tripled in the last 20 years. While this surgery is usually safe and effective, there are risks involved. Advancements in surgical techniques and new tools have lessened the chances of complications after the surgery. However, these risks should not be overlooked. Doctors need to be aware of these potential complications, inform patients about them, and have a plan in place if they occur. The author shares his experience of performing this surgery 2579 times between 1998 and 2017. He found that overall, 7% of the cases had complications. The most common issues were difficulty swallowing (1.9% of cases), problems with the graft or hardware (1.3% of cases), and blood clots after the surgery (0.9% of cases). The author emphasizes the importance of understanding these risks and taking all possible steps to avoid them. If these complications do occur, they should be managed appropriately.

FAQs

  1. What is Anterior cervical discectomy and fusion (ACDF) surgery?
  2. What are some common complications of Anterior cervical discectomy and fusion (ACDF) surgery?
  3. How has the prevalence of Anterior cervical discectomy and fusion (ACDF) surgeries changed over the past two decades?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to follow the post-operative care instructions carefully to minimize the risk of complications. This may include avoiding heavy lifting, following a physical therapy regimen, and taking prescribed medications as directed. It is also important to keep all follow-up appointments with your healthcare provider to monitor your recovery progress.

Suitable For

Patients who are typically recommended for discectomy are those who have tried conservative treatments such as physical therapy, medication, and cortisone injections without success. These patients typically have symptoms such as neck or arm pain, weakness, or numbness due to a herniated disc in the neck. They may also have spinal cord compression or nerve root compression causing these symptoms. Discectomy is often recommended for patients who have failed conservative treatments and have persistent and severe symptoms that significantly impact their quality of life.

Timeline

Before the discectomy:

  1. Patient experiences neck pain, numbness, weakness, or tingling in the arms or hands.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis of a herniated disc.
  3. Doctor recommends conservative treatments such as physical therapy, medications, or injections to manage symptoms.
  4. If conservative treatments are not effective, doctor recommends discectomy surgery as a last resort option.

After the discectomy:

  1. Patient undergoes pre-operative evaluations and preparations for surgery.
  2. Discectomy surgery is performed to remove the herniated disc and relieve pressure on the spinal nerves.
  3. Patient may experience relief from symptoms immediately after surgery, but may also have post-operative pain and discomfort.
  4. Patient is monitored closely for any complications such as difficulty swallowing, problems with the graft or hardware, or blood clots.
  5. Patient undergoes post-operative rehabilitation and physical therapy to aid in recovery and prevent future issues.
  6. Patient follows up with their doctor for regular check-ups and monitoring to track their recovery progress and address any concerns or complications that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy surgery?
  2. How likely am I to experience complications based on my specific health condition and medical history?
  3. What steps can be taken to minimize the risk of complications during and after the surgery?
  4. How experienced are you in performing discectomy surgeries, and what is your success rate?
  5. What is the expected recovery time and rehabilitation process after the surgery?
  6. Are there any alternative treatment options to consider before proceeding with a discectomy?
  7. How will my pain and mobility be improved after the surgery?
  8. What are the long-term outcomes and potential risks for this surgery in terms of my overall health?
  9. What should I do if I experience any unexpected symptoms or complications after the surgery?
  10. Are there any specific lifestyle changes or precautions I should take to prevent further complications in the future?

Reference

Authors: Robertson SC, Ashley MR. Journal: Acta Neurochir Suppl. 2023;130:169-178. doi: 10.1007/978-3-030-12887-6_20. PMID: 37548736