Skip to main content
Log in

Immediate (0–6 h), early (6–72 h) and late (>72 h) complications after anterior cervical discectomy with fusion for cervical disc degeneration; discharge six hours after operation is feasible

  • Clinical Article
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Objectives. The introduction of minimally invasive techniques and total intravenous anaesthesia has led to reports of the performance of anterior cervical discectomy and fusion as an outpatient. The safety of this approach, requires information about the complications presenting within this period. The aim of this study was to assess the rates and types of immediate (0–6 h), early (6–72 h) and late (>72 h) complications after anterior cervical discectomy with fusion.

Methods. We prospectively studied complications after anterior cervical discectomy with fusion in patients with degenerative cervical disc disease. There were 390 consecutive operations: 278 fused with autologous iliac crest bone graft and 112 with a PEEK (Polyetheretherketone) graft.

Results. No patient died. Thirty seven patients (9%) experienced one or more complications that could be related to the operation. These presented in the immediate, early and late periods in 17, 1 and 19 patients, respectively. Thus, 18/37 complications were detected before discharge from the neurosurgical department 48–72 h after operation and of these 17 (4.2%) were detected within the first 6 h after surgery. Each of the five potentially life-threatening neck hematomas was detected within 6 h (immediate).

Conclusions. After anterior cervical discectomy and fusion, a 6 h postoperative observation period followed by discharge from the neurosurgical unit is likely to be as safe as observation as an inpatient for a longer period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • RI Apfelbaum MD Kriskovich JR Haller (2000) ArticleTitleOn the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery Spine 25 2906–2912 Occurrence Handle11074678 Occurrence Handle10.1097/00007632-200011150-00012 Occurrence Handle1:STN:280:DC%2BD38%2FgsFyntQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • R Bazaz MJ Lee JU Yoo (2002) ArticleTitleIncidence of dysphagia after anterior cervical spine surgery: a prospective study Spine 27 2453–2458 Occurrence Handle12435974 Occurrence Handle10.1097/00007632-200211150-00007

    Article  PubMed  Google Scholar 

  • H Bertalanffy HR Eggert (1988) ArticleTitleClinical long-term results of anterior discectomy without fusion for treatment of cervical radiculopathy and myelopathy. A follow-up of 164 cases Acta Neurochir (Wien) 90 127–135 Occurrence Handle10.1007/BF01560567 Occurrence Handle1:STN:280:DyaL1c7otVCgsQ%3D%3D

    Article  CAS  Google Scholar 

  • H Bertalanffy HR Eggert (1989) ArticleTitleComplications of anterior cervical discectomy without fusion in 450 consecutive patients Acta Neurochir (Wien) 99 41–50 Occurrence Handle10.1007/BF01407775 Occurrence Handle1:STN:280:DyaL1MzjtlersQ%3D%3D

    Article  CAS  Google Scholar 

  • M Boakye PV Mummaneni M Garrett et al. (2005) ArticleTitleAnterior cervical discectomy and fusion involving a polyetheretherketone spacer and bone morphogenetic protein J Neurosurg Spine 2 521–525 Occurrence Handle15945426 Occurrence Handle10.3171/spi.2005.2.5.0521

    Article  PubMed  Google Scholar 

  • JP Burke PC Gerszten WC Welch (2005) ArticleTitleIatrogenic vertebral artery injury during anterior cervical spine surgery Spine J 5 508–514 Occurrence Handle16153577 Occurrence Handle10.1016/j.spinee.2004.11.015

    Article  PubMed  Google Scholar 

  • JC Cauthen RE Kinard JB Vogler et al. (1998) ArticleTitleOutcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients Spine 23 188–192 Occurrence Handle9474724 Occurrence Handle10.1097/00007632-199801150-00008 Occurrence Handle1:STN:280:DyaK1c7jsFSltw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • DY Cho WY Lee PC Sheu (2004) ArticleTitleTreatment of multilevel cervical fusion with cages Surg Neurol 62 378–385 Occurrence Handle15518835 Occurrence Handle10.1016/j.surneu.2004.01.021

    Article  PubMed  Google Scholar 

  • DY Cho WR Liau WY Lee et al. (2002) ArticleTitlePreliminary experience using a polyetheretherketone (PEEK) cage in the treatment of cervical disc disease Neurosurgery 51 1343–1349 Occurrence Handle12445338 Occurrence Handle10.1097/00006123-200212000-00003

    Article  PubMed  Google Scholar 

  • JW Donaldson PB Nelson (2002) ArticleTitleAnterior cervical discectomy without interbody fusion Surg Neurol 57 219–224 Occurrence Handle12173388 Occurrence Handle10.1016/S0090-3019(02)00638-9

    Article  PubMed  Google Scholar 

  • JO Espersen M Buhl EF Eriksen et al. (1984) ArticleTitleTreatment of cervical disc disease using Cloward’s technique. I. General results, effect of different operative methods and complications in 1,106 patients Acta Neurochir (Wien) 70 97–114 Occurrence Handle10.1007/BF01406047 Occurrence Handle1:STN:280:DyaL2c3ltlWhuw%3D%3D

    Article  CAS  Google Scholar 

  • T Floyd D Ohnmeiss (2000) ArticleTitleA meta-analysis of autograft versus allograft in anterior cervical fusion Eur Spine J 9 398–403 Occurrence Handle11057533 Occurrence Handle10.1007/s005860000160 Occurrence Handle1:STN:280:DC%2BD3crgsFyksg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • S Garcia ML Lozano JM Gatell et al. (1991) ArticleTitleProphylaxis against infection. Single-dose cefonicid compared with multiple-dose cefamandole J Bone Joint Surg Am 73 1044–1048 Occurrence Handle1874767 Occurrence Handle1:STN:280:DyaK3MzktVOquw%3D%3D

    PubMed  CAS  Google Scholar 

  • RF Gaudinez GM English JS Gebhard et al. (2000) ArticleTitleEsophageal perforations after anterior cervical surgery J Spinal Disord 13 77–84 Occurrence Handle10710155 Occurrence Handle10.1097/00002517-200002000-00015 Occurrence Handle1:STN:280:DC%2BD3c7ntleruw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • DR Gore SB Sepic (1998) ArticleTitleAnterior discectomy and fusion for painful cervical disc disease. A report of 50 patients with an average follow-up of 21 years Spine 23 2047–2051 Occurrence Handle9794047 Occurrence Handle10.1097/00007632-199810010-00002 Occurrence Handle1:STN:280:DyaK1M%2FhtVClsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JJ Graham (1989) ArticleTitleComplications of cervical spine surgery. A five-year report on a survey of the membership of the Cervical Spine Research Society by the Morbidity and Mortality Committee Spine 14 1046–1050 Occurrence Handle2588051 Occurrence Handle10.1097/00007632-198910000-00003 Occurrence Handle1:STN:280:DyaK3c%2FmvFOgsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • RJ Hacker JC Cauthen TJ Gilbert et al. (2000) ArticleTitleA prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage Spine 25 2646–2654 Occurrence Handle11034651 Occurrence Handle10.1097/00007632-200010150-00017 Occurrence Handle1:STN:280:DC%2BD3M%2FkvVWnug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • BS Harhangi T Menovsky HA Wurzer (2005) ArticleTitleHemothorax as a complication after anterior cervical discectomy: case report Neurosurgery 56 E871 Occurrence Handle15792530 Occurrence Handle10.1227/01.NEU.0000156489.12893.92

    Article  PubMed  Google Scholar 

  • RF Heary RP Schlenk TA Sacchieri et al. (2002) ArticleTitlePersistent iliac crest donor site pain: independent outcome assessment Neurosurgery 50 510–516 Occurrence Handle11841718 Occurrence Handle10.1097/00006123-200203000-00015

    Article  PubMed  Google Scholar 

  • C Hill R Flamant F Mazas et al. (1981) ArticleTitleProphylactic cefazolin versus placebo in total hip replacement. Report of a multicentre double-blind randomised trial Lancet 1 795–796 Occurrence Handle6111670 Occurrence Handle10.1016/S0140-6736(81)92678-7 Occurrence Handle1:STN:280:DyaL3M7ntFOrsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MS Luer J Hatton (1993) ArticleTitleAppropriateness of antibiotic selection and use in laminectomy and microdiskectomy Am J Hosp Pharm 50 667–670 Occurrence Handle8470680 Occurrence Handle1:STN:280:DyaK3s3ivVSktA%3D%3D

    PubMed  CAS  Google Scholar 

  • DR Mauerhan CL Nelson DL Smith et al. (1994) ArticleTitleProphylaxis against infection in total joint arthroplasty. One day of cefuroxime compared with three days of cefazolin J Bone Joint Surg Am 76 39–45 Occurrence Handle8288664 Occurrence Handle1:STN:280:DyaK2c7hslGgsw%3D%3D

    PubMed  CAS  Google Scholar 

  • JF Morpeth MF Williams (2000) ArticleTitleVocal fold paralysis after anterior cervical diskectomy and fusion Laryngoscope 110 43–46 Occurrence Handle10646714 Occurrence Handle10.1097/00005537-200001000-00009 Occurrence Handle1:STN:280:DC%2BD3c7htVKgtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JL Netterville MJ Koriwchak M Winkle et al. (1996) ArticleTitleVocal fold paralysis following the anterior approach to the cervical spine Ann Otol Rhinol Laryngol 105 85–91 Occurrence Handle8659941 Occurrence Handle1:STN:280:DyaK283itlGrsg%3D%3D

    PubMed  CAS  Google Scholar 

  • J Olak K Jeyasingham C Forrester-Wood et al. (1991) ArticleTitleRandomized trial of one-dose versus six-dose cefazolin prophylaxis in elective general thoracic surgery Ann Thorac Surg 51 956–958 Occurrence Handle2039326 Occurrence Handle1:STN:280:DyaK3M3ksl2gsw%3D%3D Occurrence Handle10.1016/0003-4975(91)91014-M

    Article  PubMed  CAS  Google Scholar 

  • M Pedram L Castagnera X Carat et al. (2003) ArticleTitlePharyngolaryngeal lesions in patients undergoing cervical spine surgery through the anterior approach: contribution of methylprednisolone Eur Spine J 12 84–90 Occurrence Handle12592551 Occurrence Handle10.1007/s00586-003-0626-8 Occurrence Handle1:STN:280:DC%2BD3s%2FnvF2itg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • A Peolsson L Vavruch B Oberg (2006) ArticleTitleCan the results 6 months after anterior cervical decompression and fusion identify patients who will have remaining deficit at long-term? Disabil Rehabil 28 117–124 Occurrence Handle16393842 Occurrence Handle10.1080/09638280500163752

    Article  PubMed  Google Scholar 

  • RA Robinson GW Smith (1955) ArticleTitleAnterolateral cervical disc removal and interbody fusion for cervical disc syndrome Bull Johs Hopkins Hospital 96 223–224

    Google Scholar 

  • E Rubinstein G Findler P Amit et al. (1994) ArticleTitlePerioperative prophylactic cephazolin in spinal surgery. A double-blind placebo-controlled trial J Bone Joint Surg Br 76 99–102 Occurrence Handle8300691 Occurrence Handle1:STN:280:DyaK2c7jt1WgtA%3D%3D

    PubMed  CAS  Google Scholar 

  • R Saginur D Croteau MG Bergeron (2000) ArticleTitleComparative efficacy of teicoplanin and cefazolin for cardiac operation prophylaxis in 3027 patients. The ESPRIT Group J Thorac Cardiovasc Surg 120 1120–1130 Occurrence Handle11088036 Occurrence Handle10.1067/mtc.2000.110384 Occurrence Handle1:CAS:528:DC%2BD3MXhsVem

    Article  PubMed  CAS  Google Scholar 

  • HR Silvers PJ Lewis LS Suddaby et al. (1996) ArticleTitleDay surgery for cervical microdiscectomy: is it safe and effective? J Spinal Disord 9 287–293 Occurrence Handle8877954 Occurrence Handle10.1097/00002517-199608000-00003 Occurrence Handle1:STN:280:DyaK2s%2Fjt1Snug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • CA Smith-Hammond KC New R Pietrobon et al. (2004) ArticleTitleProspective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures Spine 29 1441–1446 Occurrence Handle15223936 Occurrence Handle10.1097/01.BRS.0000129100.59913.EA

    Article  PubMed  Google Scholar 

  • M Stewart RA Johnston I Stewart et al. (1995) ArticleTitleSwallowing performance following anterior cervical spine surgery Br J Neurosurg 9 605–609 Occurrence Handle8561932 Occurrence Handle10.1080/02688699550040882 Occurrence Handle1:STN:280:DyaK287is1Ogug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JR Stieber K Brown GD Donald et al. (2005) ArticleTitleAnterior cervical decompression and fusion with plate fixation as an outpatient procedure Spine J 5 503–507 Occurrence Handle16153576 Occurrence Handle10.1016/j.spinee.2005.01.011

    Article  PubMed  Google Scholar 

  • BC Vrouenraets HD Been R Brouwer-Mladin et al. (2004) ArticleTitleEsophageal perforation associated with cervical spine surgery: report of two cases and review of the literature Dig Surg 21 246–249 Occurrence Handle15237259 Occurrence Handle10.1159/000079495 Occurrence Handle1:STN:280:DC%2BD2czntVKntA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JE Wilberger JW Bost JC Maroon (1995) ArticleTitleAmbulatory surgery is safe and effective in radicular disc disease Spine 20 861–862 Occurrence Handle7701404 Occurrence Handle10.1097/00007632-199504000-00026 Occurrence Handle1:STN:280:DyaK2M3hsF2gsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • SM Zeidman TB Ducker J Raycroft (1997) ArticleTitleTrends and complications in cervical spine surgery: 1989–1993 J Spinal Disord 10 523–526 Occurrence Handle9438819 Occurrence Handle10.1097/00002517-199712000-00012 Occurrence Handle1:STN:280:DyaK1c%2FpvFKmtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Lied.

Additional information

Correspondence: Bjarne Lied, M.D., Department of Neurosurgery, Ullevål University Hospital, NO-0407 Oslo, Norway.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lied, B., Sundseth, J. & Helseth, E. Immediate (0–6 h), early (6–72 h) and late (>72 h) complications after anterior cervical discectomy with fusion for cervical disc degeneration; discharge six hours after operation is feasible. Acta Neurochir (Wien) 150, 111–118 (2008). https://doi.org/10.1007/s00701-007-1472-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-007-1472-y

Navigation