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

Abstract

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.