Anterior Cervical Discectomy and Fusion Complications

As with any surgery, there are a number of possible risks and complications of anterior cervical discectomy surgery.

The rate of occurrence of potential risks and complications is highly variable and dependent mainly on a combination of:

  1. The results of the individual surgeon with ACDF surgery (meaning that the frequency of complications varies between surgeons), and;
  2. Individual patient risk factors, such as the condition of the disc, the patient’s physical condition (bone strength, diabetes, etc.), whether or not the patient smokes, and other factors.

For an ACDF surgery, the main potential risks and complications that tend to occur include:

  • Inadequate symptom relief after the surgery
  • Failure of bone graft healing to create a fusion (a non-union, or pseudarthrosis)
  • Persistent swallowing or speech disturbance
  • Nerve root damage
  • Damage to the spinal cord (about 1 in 10,000)
  • Bleeding
  • Infection
  • Damage to the trachea/esophagus.
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Also, the small nerve that supplies innervation to the vocal cords (recurrent laryngeal nerve) will sometimes not function for several months after neck surgery because of retraction during the procedure. This complication can cause temporary hoarseness. Retraction of the esophagus can also produce difficulty with swallowing, which usually resolves within days but can last weeks to months. Rarely, it can result in permanent difficulty swallowing.

There is little chance of a recurrent disc herniation because most of the disc is removed with this type of surgery.

There is also a chance of developing symptoms related to reduced range of motion around the fused segment of the spine, termed Adjacent Segment Degeneration or Adjacent Segment Disease (ASD). Studies show a wide variability in how often this occurs following ACDF. More research is needed to fully understand how often this develops and relative degree of symptoms associated with it.

Patients are advised to discuss the potential risks and complications with their surgeon prior to having ACDF surgery.