Our Summary

This research paper examines two commonly performed operations to treat neck pain and spinal cord compression - Anterior Cervical Discectomy and Fusion (ACDF) and Cervical Disc Arthroplasty (CDA). The researchers looked at data from over 430,000 patients who had either operation between 2011 and 2021. They specifically looked at how often the surgeries were performed, the rate of complications after surgery, and whether any patients needed another surgery.

They found that the use of ACDF increased by 25.25% between 2011 and 2014, while the use of CDA dramatically increased by 654.24% between 2011 and 2019. After that, the use of both procedures plateaued.

The researchers found that both surgeries had a relatively low rate of complications. ACDF had a 12.20% complication rate and CDA had an 8.77% complication rate. The most common complications were needing another surgery and difficulty swallowing. Patients who had ACDF, especially those who had more than one level of their spine operated on, generally had more complications and were more likely to need another surgery than patients who had CDA.

In conclusion, while the use of ACDF has remained stable since 2014, the use of CDA has dramatically increased over the past decade. CDA also had a lower rate of complications and less need for additional surgeries. However, the researchers noted that they didn’t have enough data to recommend one procedure over the other for individual patients.

FAQs

  1. What are the Anterior Cervical Discectomy and Fusion (ACDF) and Cervical Disc Arthroplasty (CDA) procedures?
  2. How has the use of ACDF and CDA changed between 2011 and 2021?
  3. What are the complication rates for the ACDF and CDA procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to carefully follow post-operative instructions, including restrictions on physical activity and proper wound care, to ensure a successful recovery and minimize the risk of complications. Additionally, maintaining a healthy lifestyle, including regular exercise and proper nutrition, can help support the healing process and prevent future spine issues. Lastly, attending follow-up appointments with your healthcare provider is important to monitor your progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for discectomy are those who have neck pain and spinal cord compression due to a herniated or degenerative disc in the cervical spine. These patients may have symptoms such as arm pain, weakness, numbness, or tingling, as well as difficulty with coordination and balance. Patients who have not responded to conservative treatments such as physical therapy, medications, and injections may be candidates for discectomy surgery. Additionally, patients with severe symptoms that significantly impact their daily activities and quality of life may also be recommended for surgery. Ultimately, the decision to undergo discectomy surgery should be made in consultation with a spine specialist who can evaluate the patient’s specific condition and recommend the most appropriate treatment option.

Timeline

Before undergoing a discectomy, a patient will typically experience symptoms such as neck or back pain, weakness, numbness, or tingling in the arms or legs, and difficulty walking. They may have tried conservative treatments such as physical therapy, medications, or injections to manage their symptoms.

After a discectomy, the patient will likely experience some pain and discomfort at the surgical site. They may also have restrictions on their activities and movements for a period of time to allow their body to heal properly. Physical therapy may be recommended to help regain strength and mobility in the affected area.

In the months following the surgery, the patient should gradually experience a reduction in their symptoms and an improvement in their overall quality of life. However, it is important for the patient to follow their post-operative care plan and attend follow-up appointments with their surgeon to ensure a successful recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy include:

  1. What are the risks and potential complications associated with the specific type of discectomy procedure being recommended?
  2. How successful is this type of discectomy in relieving my specific symptoms?
  3. Will I need physical therapy or other rehabilitation after the surgery?
  4. How long is the recovery period and what can I expect in terms of pain management?
  5. What are the chances of needing another surgery in the future after this discectomy?
  6. Are there any alternative treatments or procedures that could be considered instead of a discectomy?
  7. How many of these procedures have you performed and what is your success rate?
  8. What should I do to prepare for the surgery, both physically and mentally?
  9. Are there any specific lifestyle changes or restrictions I should follow after the surgery?
  10. How soon can I expect to return to work or normal activities after the surgery?

Reference

Authors: Singh M, Balmaceno-Criss M, Anderson G, Parhar K, Daher M, Gregorczyk J, Liu J, McDonald CL, Diebo BG, Daniels AH. Journal: Spine J. 2024 Aug;24(8):1342-1351. doi: 10.1016/j.spinee.2024.02.016. Epub 2024 Feb 24. PMID: 38408519