Risks of Anterior Cervical Surgery
What are the risks?
No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots (deep vein thrombosis), and reactions to anesthesia. Specific complications related to ACDF may include:
Hoarseness and swallowing difficulties
In some cases, temporary hoarseness can occur. The recurrent laryngeal nerve, which controls the vocal cords, is affected during surgery. It may take several months for this nerve to recover. In rare cases (less than 1/250) hoarseness and swallowing problems may persist and need further treatment with an ear, nose and throat specialist.
Vertebrae failing to fuse
There are many reasons why bones do not fuse together. Common ones include smoking, osteoporosis, obesity, and malnutrition. Smoking is by far the greatest factor that can prevent fusion. Nicotine is a toxin that inhibits bone-growing cells. If you continue to smoke after your spinal surgery, you could undermine the fusion process.
Metal screws and plates used to stabilize the spine are called “hardware.” The hardware may move or break before the bones are completely fused. If this occurs, a second surgery may be needed to fix or replace the hardware.
Bone graft migration.
In rare cases (1 to 2%), the bone graft can move from the correct position between the vertebrae soon after surgery. This is more likely to occur if hardware (plates and screws) is not used or if multiple vertebral levels are fused. If this occurs, a second surgery may be necessary.
Nerve damage or persistent pain
Any spine surgery comes with the risk of damaging the nerves or spinal cord. Damage can cause numbness or even paralysis. However, the most common cause of persistent pain is nerve damage from the disc herniation itself. Some disc herniations may permanently damage a nerve making it unresponsive to surgery. Like furniture on the carpet, the compressed nerve doesn’t spring back. In these cases, spinal cord stimulation or other treatments may provide relief.
Adjacent Segment Pathology
These are risks particularly relevant to a patients individual situation ( i.e a musician would place a premium on fine hand function , whilst a labourer would value stability. Material risks are discussed during the process of taylored, explicit consent. Dr Nair encourages you to vocalise your expectations of any proposed surgery.