Abstract

Introduction: Cervical disc herniation is a common degenerative spine condition that may lead to radiculopathy and/or myelopathy. Among surgical treatment options, anterior cervical discectomy and fusion (ACDF) is one of the most frequently performed and effective procedures. However, postoperative complications can influence both surgical outcomes and patient prognosis. Reported complication rates in the literature vary widely, and large, single-center case series remain limited. This study retrospectively evaluates the incidence, types, and distribution of complications following ACDF in a large patient cohort.

Materials and Methods: A retrospective analysis was conducted on 288 patients aged ≥18 years who underwent ACDF between 2012 and 2023 at our institution and had complete medical records. Data regarding age, gender, surgical level (single vs. multilevel), affected disc level, and complication types were recorded. Complications were categorized into seven main groups.

Results: The mean patient age was 46.8 years, with an equal male-to-female ratio (1:1). The most commonly operated levels were C5–6 (33.6%) and C6–7 (28.1%), while multilevel surgeries accounted for 29.1% of all cases. Overall, complications were observed in 22 patients (7.63%). The most frequent complication was residual disc material requiring reoperation (3.1%), followed by recurrent laryngeal nerve injury (1.7%). Postoperative hematoma, neurological deficits, and infectious complications (abscess/discitis) were each observed in 0.69% of patients. Rare complications included cerebrospinal fluid leakage (0.34%) and inferior thyroid artery injury (0.34%). Notably, no cases of esophageal injury or Horner’s syndrome were identified during the study period. The low complication rates observed may be attributed to strict adherence to surgical principles and standardized intraoperative protocols.

Conclusion: This single-center study, based on a relatively large and homogeneously managed surgical cohort, provides important insight into the safety profile of ACDF. The low complication rates observed suggest that ACDF is a reliable and effective surgical technique when appropriate surgical principles are followed. Careful patient selection, meticulous surgical technique, and close postoperative monitoring play a key role in minimizing complication risk.

Keywords: anterior cervical discectomy, spinal fusion, cervical disc herniation, surgical complications, reoperation, recurrent laryngeal nerve injury, spine surgery

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Örnek V, Ergüven M, Poyraz A, Öztürk S, Ünal TC, Sabancı PA. Complications following anterior cervical discectomy and fusion: A retrospective evaluation of a large single-center case seriesidiopathic normal pressure hydrocephalus. Sinir Sistemi Cerrahisi Derg 2025;10(1):26-35. https://doi.org/10.54306/sscd.2025.212