Our Summary

This study aimed to understand surgeons’ opinions of the risks associated with a type of neck surgery called anterior cervical discectomy and fusion. Researchers surveyed attendees at a Cervical Spine Research Society meeting, asking them to categorize 18 potential complications as “common and acceptable,” “uncommon and acceptable,” “uncommon and sometimes acceptable,” or “uncommon and unacceptable.”

Out of 150 surveys, 115 responses were received. Most respondents were orthopedic surgeons based in the US. They generally agreed that certain complications - like surgery at the wrong level, damage to the esophagus, leaving a drain in after surgery, and injuring the spinal cord - were rare and unacceptable. Other complications, like difficulty swallowing and issues with the area next to the surgery site, were deemed common but acceptable.

The survey found that the surgeon’s experience and specialty didn’t really affect their responses. However, where the surgeon practiced did make a difference. Surgeons outside the US were more likely to consider complications both uncommon and unacceptable compared to those in the US.

The results of this study can assist in open communication within the field of spine surgery and inform future efforts to improve quality and establish best practices.

FAQs

  1. What was the goal of the study on anterior cervical discectomy and fusion?
  2. Did the surgeon’s experience and specialty influence their perception of the risks associated with anterior cervical discectomy and fusion?
  3. Does the location of the surgeon’s practice influence their view on the acceptability and commonality of complications associated with anterior cervical discectomy and fusion?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to discuss the potential complications and risks associated with the surgery. It is important for patients to have a clear understanding of what to expect before undergoing the procedure. Patients should also be aware that some complications, while rare, may still occur and should be considered as part of the decision-making process. Additionally, patients should feel comfortable asking their surgeon any questions or expressing any concerns they may have.

Suitable For

Patients who are typically recommended for discectomy are those who have a herniated disc in the spine that is causing symptoms such as severe pain, numbness, weakness, or tingling in the arms or legs. Discectomy is often recommended when conservative treatments such as physical therapy, medication, and injections have not provided relief. It is important for patients to discuss their specific symptoms and medical history with their healthcare provider to determine if discectomy is the right treatment option for them.

Timeline

Before a patient undergoes a discectomy, they typically experience symptoms such as back or neck pain, numbness or weakness in the arms or legs, and possibly difficulty walking or standing for long periods. They may have already tried conservative treatments such as physical therapy, medication, and injections without success.

After a discectomy, the patient will likely experience some pain and discomfort at the surgical site, which can be managed with pain medication. They may also need to undergo physical therapy to regain strength and flexibility in the affected area. In some cases, patients may experience complications such as infection, nerve damage, or a recurrence of the herniated disc, which may require further treatment.

Overall, the goal of a discectomy is to relieve the patient’s symptoms and improve their quality of life by removing the herniated disc and alleviating pressure on the spinal nerves. With proper post-operative care and rehabilitation, most patients can expect to have a successful recovery and return to their normal activities.

What to Ask Your Doctor

Questions a patient should ask their doctor about discectomy based on this study may include:

  1. What are the potential complications associated with anterior cervical discectomy and fusion?
  2. How common are these complications, and are they considered acceptable by medical professionals?
  3. Are there any specific complications that are rare and unacceptable that I should be aware of?
  4. How does the surgeon’s experience and specialty impact the likelihood of complications during the surgery?
  5. Does the location where the surgeon practices affect the likelihood of complications or their acceptance level?
  6. What steps do you take to minimize the risk of complications during the discectomy procedure?
  7. Can you provide information on your success rates and previous patient outcomes following discectomy surgery?
  8. Are there any alternative treatment options to consider before proceeding with discectomy surgery?
  9. What is the post-operative care plan and recovery process for a discectomy procedure?
  10. How will you monitor and address any potential complications that may arise after the surgery?

Reference

Authors: Wilson JR, Radcliff K, Schroeder G, Booth M, Lucasti C, Fehlings M, Ahmad N, Vaccaro A, Arnold P, Sciubba D, Ching A, Smith J, Shaffrey C, Singh K, Darden B, Daffner S, Cheng I, Ghogawala Z, Ludwig S, Buchowski J, Brodke D, Wang J, Lehman RA, Hilibrand A, Yoon T, Grauer J, Dailey A, Steinmetz M, Harrop JS. Journal: Clin Spine Surg. 2018 Jun;31(5):E270-E277. doi: 10.1097/BSD.0000000000000645. PMID: 29708891