Evidence map›Paper›PMID 31528438›Full record

ReviewSurgical neurology international2019

A Review of Complication Rates for Anterior Cervical Diskectomy and Fusion (ACDF).

Nancy E Epstein

2 registry-linked trialsOpen access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Surgical neurology international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 178 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
178citing papers in PubMed, 9 pooled it
25.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04550923 phase4unknown statusnot on this mapstarted 2020, after this paper: background citation

Comparison of Rigid and Non-Rigid Interbody Fusion Device for Cervical Degenerative Disc Disease in Adults - A Randomized, Prospective, Multicenter Clinical Trial

TypeinterventionalSponsorNational Taiwan University HospitalRan2020 to 2025Enrolled180ConditionsCervical Disc DegenerationArmsZ-Brace interbody fusion device, PEEK interbody fusion device
NCT06027827 unknown statusnot on this mapstarted 2022, after this paper: background citation

Impact of Lateral Bone Grafting With Intraoperative Fusion in ACDF on Clinical Outcomes

TypeobservationalSponsorXuanwu Hospital, BeijingRan2022 to 2024Enrolled58ConditionsCervical SpondylosisArmsAddition of fusion device lateral bone graft
3 · Its place in the literature

Who cites it

178 citing papers in PubMed, 9 syntheses or guidelines pooled it, 337 citations in OpenAlex.

  1. Pooled it
  2. Delayed spontaneous expulsion of a stand-alone cervical interbody cage through the oral cavity: a case report and review of the literature.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Pooled it
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  9. The retropharyngeal steroid use during operation on the fusion rate and dysphagia after ACDF? A systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
    Pooled it
  10. Trial
  11. Preoperative disability is independently associated with postoperative care intensity following anterior cervical discectomy and fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  12. Is the zero-profile anchored cage sufficient and safe for Microscope-assisted anterior cervical discectomy and fusion with oblique resection of posterior endplate in the treatment of degenerative cervical disease? A preliminary study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  13. Article
  14. Impact of mental health disorders and perioperative outcomes following anterior cervical discectomy and fusion (ACDF): a national inpatient analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  15. Perioperative management of antithrombotic therapy in elderly patients undergoing elective ACDF: implementation and outcomes of a standardized institutional protocol.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  16. The impact of operative level on reoperation rates and short-term patient-reported outcomes in 3-level anterior cervical discectomy and fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  17. Article
  18. The inter-sternohyoid median (ISM) approach: a novel median anterior corridor to the cervical spine - anatomical study and preliminary clinical application.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  19. Review
  20. Review

118 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Nancy E EpsteinProfessor 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.
State University of New York · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere 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).

methodsMultiple studies analyzed the risks and complications rates attributed to ACDF.

resultsIn 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's 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).

conclusionsComplications attributed to ACDF included; dysphagia, hematoma, worsening myelopathy, recurrent laryngeal nerve palsy, CSF leaks, wound infection, radiculopathy, Horner's 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.

Indexed as

Adverse eventsAnterior cervicalComplicationsDiskectomyFusionRisks

Identifiers

PMID31528438
PMCPMC6744804
OpenAlexW2969590410

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.