Frequency and acceptability of adverse events after anterior cervical discectomy and fusion

Jefferson R. Wilson, Kris Radcliff, Gregory Schroeder, Madison Booth, Christopher Lucasti, Michael Fehlings, Nassr Ahmad, Alexander Vaccaro, Paul Arnold, Daniel Sciubba, Alex Ching, Justin Smith, Christopher Shaffrey, Kern Singh, Bruce Darden, Scott Daffner, Ivan Cheng, Zoher Ghogawala, Steven Ludwig, Jacob BuchowskiDarrel Brodke, Jeffrey Wang, Ronald A. Lehman, Alan Hilibrand, Tim Yoon, Jonathan Grauer, Andrew Dailey, Michael Steinmetz, James S. Harrop

Research output: Contribution to journalReview article

Abstract

Purpose: Anterior cervical discectomy and fusion has a low but well-established profile of adverse events. The goal of this study was to gauge surgeon opinion regarding the frequency and acceptability of these events. Methods: A 2-page survey was distributed to attendees at the 2015 Cervical Spine Research Society (CSRS) meeting. Respondents were asked to categorize 18 anterior cervical discectomy and fusion-related adverse events as either: "common and acceptable," "uncommon and acceptable," "uncommon and sometimes acceptable," or "uncommon and unacceptable." Results were compiled to generate the relative frequency of these responses for each complication. Responses for each complication event were also compared between respondents based on practice location (US vs. non-US), primary specialty (orthopedics vs. neurosurgery) and years in practice. Results: Of 150 surveys distributed, 115 responses were received (76.7% response rate), with the majority of respondents found to be US-based (71.3%) orthopedic surgeons (82.6%). Wrong level surgery, esophageal injury, retained drain, and spinal cord injury were considered by most to be unacceptable and uncommon complications. Dysphagia and adjacent segment disease occurred most often, but were deemed acceptable complications. Although surgeon experience and primary specialty had little impact on responses, practice location was found to significantly influence responses for 12 of 18 complications, with non-US surgeons found to categorize events more toward the uncommon and unacceptable end of the spectrum as compared with US surgeons. Conclusions: These results serve to aid communication and transparency within the field of spine surgery, and will help to inform future quality improvement and best practice initiatives.

Original languageEnglish (US)
Pages (from-to)E270-E277
JournalClinical spine surgery
Volume31
Issue number5
DOIs
StatePublished - Jan 1 2018

    Fingerprint

Keywords

  • Anterior cervical discectomy and fusion
  • adverse events
  • cervical spine
  • complications
  • survey

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Wilson, J. R., Radcliff, K., Schroeder, G., Booth, M., Lucasti, C., Fehlings, M., Ahmad, N., Vaccaro, A., Arnold, P., Sciubba, D., Ching, A., Smith, J., Shaffrey, C., Singh, K., Darden, B., Daffner, S., Cheng, I., Ghogawala, Z., Ludwig, S., ... Harrop, J. S. (2018). Frequency and acceptability of adverse events after anterior cervical discectomy and fusion. Clinical spine surgery, 31(5), E270-E277. https://doi.org/10.1097/BSD.0000000000000645