Complications of the Anterior Cervical Discectomy and Fusion
احسان صبحي نعمة
Authors : Muthana Ibrahim Jameel, Liwa Abdullah Ali, Ihssan S Nema , Zahraa F Al-Sharshahi
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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September 2020