Our Summary

This research study focuses on a surgical procedure called anterior cervical discectomy and fusion (ACDF), which is a type of neck surgery. Despite advances in surgical techniques and tools, there’s still a risk of surgery failure. This study looked at when and how these failures occur and how often patients needed another surgery.

To do this, the researchers collected and analyzed data from various articles about ACDF. They divided the failures into two groups: those related to the “cage” (a type of implant used in the surgery) and those related to the screws. They also used statistical tests to compare different aspects of these failures.

Out of 978 patients studied, about 14% had surgery failure within two years, and about 7% of these needed another surgery. The study found that failures related to screws usually occurred within 18 months after surgery, while failures related to the cage happened within 24 months. Moreover, the timing of cage-related failures was more varied compared to screw-related ones.

The study also found that a certain type of cage material (polyetheretherketone) was associated with a later failure time compared to another type (bioabsorbable grafts), but only in failures related to screws.

In conclusion, this study shows that the timing of surgery failures is different depending on whether the failure is related to the cage or the screws. This information is important for spine surgeons as it can help them decide whether they need to keep monitoring their patients or whether a second surgery might be necessary.

FAQs

  1. What is anterior cervical discectomy and fusion (ACDF) surgery?
  2. What percentage of patients experience surgery failure within two years of ACDF, according to the study?
  3. How does the timing of surgery failures differ based on whether it’s related to the cage or the screws in ACDF surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to allow for proper healing. Additionally, attending follow-up appointments with your surgeon is crucial to monitor your recovery and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for discectomy are those who have tried conservative treatments like physical therapy, medications, and injections for their neck or back pain caused by a herniated disc or degenerative disc disease, but have not found relief. Additionally, patients with symptoms such as severe pain, weakness, numbness, or tingling in the arms or legs that are not improving with conservative treatments may also be recommended for discectomy. It is important for patients to undergo a thorough evaluation by a spine specialist to determine if they are a good candidate for the surgery.

Timeline

Before discectomy:

  1. Patient experiences symptoms such as neck pain, arm pain, numbness, weakness, or tingling due to a herniated disc pressing on a nerve.
  2. Patient undergoes imaging tests such as MRI or CT scan to confirm the diagnosis.
  3. Patient may try conservative treatments such as physical therapy, medications, or epidural injections before considering surgery.

After discectomy:

  1. Patient undergoes ACDF surgery to remove the herniated disc and fuse the affected vertebrae together.
  2. Recovery period includes pain management, physical therapy, and restrictions on activities such as lifting or bending.
  3. Patient may experience relief from symptoms and improved neck and arm function.
  4. In some cases, patients may experience surgery failure, which can be related to the cage or screws used in the procedure.
  5. If surgery failure occurs, patients may need another surgery to address the issue, usually within 18-24 months after the initial surgery.
  6. Monitoring and follow-up with the spine surgeon is important to detect and address any potential complications or failures.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with discectomy surgery?
  2. How long is the recovery period after discectomy surgery?
  3. What are the success rates of discectomy surgery, and what factors can affect the outcomes?
  4. How often do patients require a second surgery after undergoing discectomy?
  5. What type of implant or material will be used during the surgery, and are there any specific risks associated with it?
  6. How will you monitor my progress after the surgery to ensure the best possible outcome?
  7. Are there any alternative treatments or procedures that I should consider before undergoing discectomy surgery?
  8. What can I do to optimize my recovery and maximize the chances of a successful outcome?
  9. How experienced are you in performing discectomy surgeries, and what is your success rate?
  10. Can you provide me with any patient testimonials or references from previous discectomy patients?

Reference

Authors: Dholaria N, Daulat SR, Shah S, Kelbert J, Barbagli G, Soto Rubio DT, Pico A, Hussein A, Prim M, Baaj AA. Journal: World Neurosurg. 2025 Apr;196:123784. doi: 10.1016/j.wneu.2025.123784. Epub 2025 Mar 7. PMID: 39952397