Acta Scientific Neurology (ISSN: 2582-1121)

Research Article Volume 3 Issue 9

Complications of the Anterior Cervical Discectomy and Fusion

Muthana Ibrahim Jameel1, Liwa Abdullah Ali1, Ihssan S Nema2* and Zahraa F Al-Sharshahi3

1Department of Neurosurgery, AL-Emamian alKadhimian Medical City, Baghdad, Iraq

2Professor, Department of Surgery, College of Medicine, Al-Nahrain University, Baghdad, Iraq

3BAO, Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq

*Corresponding Author: Ihssan S Nema, Professor, Department of Surgery, College of Medicine, Al-Nahrain University, Baghdad, Iraq

Received: July 23, 2020; Published: August 19, 2020

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Abstract

Background: Anterior cervical discectomy and fusion (ACDF) means removing the symptomatic disc by an anterior approach with placement of a bone graft or a synthetic cage. Many studies have shown the procedure to be effective, but associated with complications.

Objective: To document and record the type and incidence of complications associated with ACDF, and to find any predisposing factors or associated medical illnesses and other demographic factors or conditions that increase the complications.

Patients and Methods: A prospective review of 48 patients who underwent an anterior cervical discectomy and fusion between (May\2012 - July\2014) in two hospitals with an average 6 months follow up.

Results: The sample of patients was classified according to age, gender, diagnosis, complications, associated medical illnesses, level of the operation. Then the complications were analyzed according to these parameters trying to find any predisposing factors or associations. Hoarseness of voice was 79%, Dysphagia 54%, Neurapraxia 14.6%, Other medical illnesses 12%, Infection 4%, Reopening 4%, wrong diagnosis 4%, worsening 4% and Death 2%.

Conclusion: The complication rate for ACDF is low in experienced hands. Hoarseness is the most common reported complication. Dysphasia, laryngeal edema or a sensation of a lump in the throat are also reported. Associated medical illnesses especially asthmatics and smokers and any patient with chronic cough or respiratory problems are the major cause of complication. Also there is marked association of complications in patients with multisystemic chronic diseases.

Keywords: Anterior Cervical Discectomy and Fusion (ACDF); Bone Graft; Fascial Layer

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References

  1. Murphy MG and Gado M. “Anterior cervical discectomy without interbody bone graft”. Journal of Neurosurgery1 (2009): 71-74.
  2. Hoang Le., et al. “Historical review of cervical arthroplasty”. Neurosurgery Focus3 (2004): E1.
  3. Omeis I., et al. “History of instrumentation for stabilization of the subaxial cervical spine”. Neurosurgery Focus1 (2004)E10.
  4. Toru Yamagata., et al. “Outcomes of contemporary use of rectangular titanium stand-alone cages in anterior cervical discectomy and fusion: Cage subsidence and cervical alignment”. Journal of clinical Neuroscience 12 (2012): 1673-1678.
  5. Jho HD and Kim WK. “Anterior microforaminotomy for treatment of cervical radiculopathy: part1, disc-preserving “functional cervical disc surgery”. Neurosurgery 51 (2012): S46-S53.
  6. Hakuba A. “Trans-unco-discal approach: A combined anterior and lateral approach to cervical discs”. Journal of Neurosurgery 45 (2006): 284-291.
  7. Martin AN. “Anterior cervical discectomy with and without interbody bone graft”. Journal of Neurosurgery3 (2011): 290-295.
  8. Hankinson HL and Wilson CB. “Use of the operating microscope in anterior cervical discectomy without fusion”. Journal of Neurosurgery4 (2012): 252-256.
  9. Hardy RW. Complication of anterior cervical surgery, in Tarlov ED (ed): Complications of Spinal Surgery. Park Ridge, American Association of Neurological Surgeons (2012): 85-95.
  10. WS Nohnen LM., et al. “Artificial disc replacement with the modular type SB Charite 111: 2 year results in 50 prospectively studies patients”. European spine Journal 8 (2005): 210-217.
  11. Wigfield JL., et al. “The new Frenchay artificial cervical joint: resuIts from a 2 year pilot study”. Spine 27 (2002): 2446-2452.
  12. Simon Bayerl., et al. “Single and multi level anterior decompression and fusion for cervical spondylotic myelopathy. A long term follow-up with a minimum of 5 years”. Clinical Neurology and Neurosurgery 115 (2013): 1966-1971.
  13. Dowd GC and Wirlh FP. “Anterior cervical discectomy: is fusion necessary?”. Journal of Neurosurgery 90 (2006): 8-12.
  14. Suat E., et al. “A comparison of changes over time and pathophysiology in cervical foraminal height after tri- cortical iliac graft or polyetheretherketone cage placement following anterior discectomy”. Journal of Neurosurgery (2007).
  15. Shiuh-Lin Hwang., et al. “Outcome Analyses of Inter body Titanium Cage Fusion Used In the Anterior Discectomy for Cervical Degenerative Disc Disease”. Journal of Spinal Disorders and Techniques4 (2005): 326-331.
  16. Cherubino P., et al. “Degenerative arthritis of the adjacent spinal joint following anterior cervical spinal fusion: clinicoradiologic and statistical correlations”. Italian Journal of Orthopaedics and Traumatology 16 (2002): 533-543.
  17. Hilibrand A S., et al. “Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis”. Journal of Bone and Joint Surgery 81 (2002): 519-528.
  18. Steel TR., et al. “Intraoperative wound infiltration With bupivacaine in patients undergoing spine surgery”. Journal of Clinic Neuroscience3 (2008): 298-303.
  19. Hunter L Y., et al. “Radiographic changes following anterior cervical fusion and Late radiographic findings after anterior cervical fusion for spondylotic myeloradiculopathy”. Spine 5 (2000): 399-401.
  20. Palma L., et al. “Favourable long-term clinical outcome after anterior cervical discectomy. A study on a series of 125 patients undergoing surgery a mean of 11 years earlier”. Acta Neurochirurgica (Wien) 152.7 (2010): 1145-1152.
  21. Martin BI., et al. “Reoperation rates following cervical spine surgery and the influence of spinal fusion procedures”. Spine 32 (2007): 382-387.
  22. H Richard Winn., et al. Neurological Surgery 6th Edition, Pathophysiology, natural history and clinical features of neck paln, cervical radiculopathy and myelopathy. Journal of Bone and Joint Surgery 10 (2002): 1872-1881.
  23. H Richard Winn., et al. “Youmans Neurological Surgery 6th edition, Modified anterior approach to the cervico-thoracic junction”. Spine 16 (1991): S542-S547.
  24. H Richard Winn., et al. Youmans Neurological Surgery 6th edition Current treatment of osteosarcoma Cancer Investigation 9 (2001): 292.
  25. H Richard Winn., et al. “Youmans Neurological Surgery 6th edition Chordoma of the mobil spine: Fifty years of experience”. Spine 31 (2006): 493.
  26. Morio Y., et al. “Correlation between operative outcomes of cervical compression myelopathy and MRI of the spinal cord”. Spine 26 (2001): 1238-1245.
  27. Feiz-Erfan I., et al. “Surgical management of cervical disc disease: from no fusion to fusion and back again”. Clinical Neurosurgery 52 (2005): 331-337.
  28. Ishihara H., et al. “Adjacent segment disease After anterior cervical lnterbody fusion”. Spine Journal 4 (2004): 624-628.
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Citation

Citation: Ihssan S Nema., et al. “Complications of the Anterior Cervical Discectomy and Fusion". Acta Scientific Neurology 3.9 (2020): .




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