PREDICTORS AND PREVENTION OF POSTOPERATIVE COMPLICATIONS IN ANTERIOR CERVICAL DISCECTOMY AND FUSION (ACDF): A CLINICAL PERSPECTIVE
DOI:
https://doi.org/10.48047/xs9rtg84Keywords:
Anterior Cervical Discectomy and Fusion, postoperative complications, predictors, prevention, dysphagia, cervical spineAbstract
Background: Anterior Cervical Discectomy and Fusion (ACDF) is a standard procedure for cervical degenerative disc disease. Despite its high success rate, postoperative complications such as dysphagia, hoarseness, and infection can compromise outcomes. Understanding predictors and implementing preventive strategies are essential for optimal results.
Objective: To evaluate the predictors and prevention of postoperative complications in ACDF patients treated at BMU over a one-year period.
Methods: A prospective observational study was conducted at the Department of Orthopaedics and Spine Surgery, BMU, from January 2017 to December 2019. A total of 52 patients who underwent single- or multi-level ACDF were included. Data regarding demographics, comorbidities, surgical parameters, and postoperative complications were collected and statistically analyzed.
Results: The mean age of patients was 47.6 ± 9.8 years; male-to-female ratio 3:2. The overall complication rate was 19.2%. Dysphagia was the most common (11.5%), followed by hoarseness (5.7%). Significant predictors included advanced age (>60 years), diabetes mellitus, multi-level fusion, and operative time >120 minutes. Preventive measures such as meticulous surgical technique, perioperative glycemic control, and early mobilization effectively reduced complications.
Conclusion: ACDF is a safe and effective procedure when appropriate preventive strategies are implemented. Identification of patient- and procedure-related predictors enables targeted intervention, optimizing surgical outcomes.
Downloads
References
Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40-A (3):607-624.
Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976). 2002;27(22):2453-2458. doi:10.1097/00007632-200211150-00007
Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 2007;32(21):2310-2317. doi:10.1097/BRS.0b013e318154c57e
Jung A, Schramm J. How to reduce recurrent laryngeal nerve palsy in anterior cervical spine surgery: a prospective observational study. Neurosurgery.2010;67(1):10-15. doi: 10.1227/01.NEU.0000370207.29108.4E
Shriver MF, Lewis DJ, Kshettry VR, Rosenbaum BP, Benzel EC, Mroz TE. Dysphagia Rates after Anterior Cervical Diskectomy and Fusion: A Systematic Review and Meta-Analysis. Global Spine J. 2016;6(7):639-650. doi:10.1055/s-0036-1579749
Kaiser MG, Haid RW Jr, Subach BR, Barnes B, Rodts GE Jr. Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery.2002;50(2):229-238. doi:10.1097/00006123-200202000-00001
Boakye M, Patil CG, Santarelli J, Ho C, Tian W, Lad SP. Cervical spondylotic myelopathy: complications and outcomes after spinal fusion. Neurosurgery. 2008;62(2):455-462. doi:10.1227/01.neu.0000316013.97226.50
Cho SK, Lu Y, Lee DH. Dysphagia following anterior cervical spinal surgery: a systematic review. Bone Joint J.2013;95-B(7):868-873. doi:10.1302/0301-620X.95B7.31029
Veeravagu A, Connolly ID, Lamsam L, et al. Surgical outcomes of cervical spondylotic myelopathy: an analysis of a national, administrative, longitudinal database. Neurosurg Focus. 2016;40(6):E11. doi:10.3171/2016.3.FOCUS1669
Epstein NE. A Review of Complication Rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int. 2019;10:100. Published 2019 Jun 7. doi:10.25259/SNI-191-2019
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Dr. K. M. Rafiqul Islam, Dr. Sheikh Forhad, Dr. Sharmin Chowdhury (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
