Behind the Procedure: Understanding Complications in Anterior Cervical Surgery

Degenerative cervical disc disease (DCDD) is a frequent cause of neck pain, radiculopathy, and disability in adults. Anterior cervical discectomy and fusion (ACDF) is widely used due to its favorable outcomes and high fusion rates but carries potential perioperative and postoperative complications that require systematic evaluation.

This study aims primarily to evaluate complication rates and patterns following ACDF and, secondarily, to assess radiographic fusion outcomes in a tertiary referral center.

We conducted a retrospective review of adult patients undergoing ACDF for DCDD at King Hussein Medical Center - Royal Medical Services, Amman, Jordan, from 2021 to 2024. Demographics, clinical presentation, operative details, radiological findings, and postoperative complications were analyzed. Patients with at least one-year radiographic follow-up were included in fusion analysis, and fusion was defined as CT trabecular bridging + no motion on flexion-extension.

Final cohort included 284 patients (342 levels). The overall complication rate was 10.56% (n=30), with dysphagia being the most frequent complication (n=6, 2.11%), which lies within the lower range of reported values in the literature (1.7%-9.5%). Radiographic fusion was observed in 98.59% (n=280) of patients with adequate imaging follow-up.

ACDF demonstrated low complication rates and high radiographic fusion in a single-center retrospective cohort. Findings should be interpreted within the limitations of the retrospective design.