{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T15:36:34Z","timestamp":1793201794308,"version":"4.5.0"},"reference-count":22,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n There are multiple complications reported for anterior cervical diskectomy and fusion (ACDF), one of the most common cervical spine operations performed in the US (e.g. estimated at 137,000 ACDF\/year).<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Multiple studies analyzed the risks and complications rates attributed to ACDF.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n In multiple studies, overall morbidity rates for ACDF varied from 13.2% to 19.3%. These included in descending order; dysphagia (1.7%-9.5%), postoperative hematoma (0.4%-5.6% (surgery required in 2.4% of 5.6%), with epidural hematoma 0.9%), exacerbation of myelopathy (0.2%-3.3%), symptomatic recurrent laryngeal nerve palsy (0.9%-3.1%), cerebrospinal fluid (CSF) leak (0.5%-1.7%), wound infection (0.1-0.9%-1.6%), increased radiculopathy (1.3%), Horner\u2019s syndrome (0.06%-1.1%), respiratory insufficiency (1.1%), esophageal perforation (0.3%-0.9%, with a mortality rate of 0.1%), and instrument failure (0.1%-0.9%). There were just single case reports of an internal jugular veing occlusion and a phrenic nerve injury. Pseudarthrosis occurred in ACDF and was dependant on the number of levels fused; 0-4.3% (1-level), 24% (2-level), 42% (3 level) to 56% (4 levels). The reoperation rate for symptomatic pseudarthrosis was 11.1%. Readmission rates for ACDF ranged from 5.1% (30 days) to 7.7% (90 days postoperatively).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Complications attributed to ACDF included; dysphagia, hematoma, worsening myelopathy, recurrent laryngeal nerve palsy, CSF leaks, wound infection, radiculopathy, Horner\u2019s Syndrome, respiratory insufficiency, esophageal perforation, and instrument failure. There were just single case reports of an internal jugular vein thrombosis, and a phrenic nerve injury. As anticipated, pseudarthrosis rates increased with the number of ACDF levels, ranging from 0-4.3% for 1 level up to 56% for 4 level fusions.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni-191-2019","type":"journal-article","created":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T07:59:33Z","timestamp":1566719973000},"page":"100","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":332,"title":["A Review of Complication Rates for Anterior Cervical Diskectomy and Fusion (ACDF)"],"prefix":"10.25259","volume":"10","author":[{"given":"Nancy E.","family":"Epstein","sequence":"first","affiliation":[{"name":"Professor of Clinical Neurosurgery, School of Medicine, State University of New York at Stony Brook, New York, and Chief of Neurosurgical Spine and Education, NYU Winthrop Hospital, NYU Winthrop NeuroScience\/Neurosurgery, Mineola, New York 11501, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2019,6,7]]},"reference":[{"issue":"1-2","key":"10.25259\/SNI-191-2019\/ref-1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/BF01407775","article-title":"Complications of anterior cervical discectomy without fusion in 450 consecutive patients","volume":"99","author":"Bertalanffy","year":"1989","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI-191-2019\/ref-2","article-title":"Incidence, Risk Factors, and Clinical Implications of Postoperative Hematoma Requiring Reoperation Following Anterior Cervical Discectomy and Fusion","author":"Bovonratwet","year":"2018","journal-title":"Spine (Phila Pa 1976)"},{"issue":"6","key":"10.25259\/SNI-191-2019\/ref-3","doi-asserted-by":"crossref","first-page":"669","DOI":"10.3171\/SPI-07\/12\/669","article-title":"Anterolateral approach to the cervical spine: major anatomical structures and landmarks. 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