Routine imaging for anterior cervical decompression and fusion procedures: a survey study establishing current...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Radiology

Background:

• Anterior cervical decompression and fusion (ACDF) procedures have increased significantly.
• ACDF imaging contributes to healthcare costs and radiation exposure.
• No standardized imaging protocol exists for ACDF.

Purpose of the Study:

• To characterize current intraoperative and postoperative imaging practices for ACDF in the United States.
• To identify variations in imaging techniques and protocols among spine surgeons.

Main Methods:

• A questionnaire was distributed to spine surgeons at the 2011 Spine Study Group meeting.
• Seventy-two responses were received, with 67 included in the analysis.
• Participants were US-based spine surgeons with fellowship training.

Main Results:

• Intraoperatively, fluoroscopy (68%) and plain radiographs (32%) are used; 60% image before incision.
• Localizer placement varied (disk vs. vertebral body), with 45% saving these images.
• All surgeons image the final construct; 74% save these images.
• Postoperative imaging before discharge occurred in recovery rooms (12%) or radiology suites (33%).
• Follow-up imaging includes lateral (96%), anteroposterior (96%), flexion-extension (46%), and CT scans (14%).

Conclusions:

• Significant variability exists in ACDF imaging practices.
• Standardization of imaging protocols is needed to optimize patient care and resource utilization.
• Further research should focus on developing evidence-based guidelines for ACDF imaging.