Martin, SC; Dabbous, BO; Ridgeon, EE; Magdum, SA; Cadoux-Hudson, TAD; Pereira, EAC
(2017)
Routine radiographs one day after anterior cervical discectomy and fusion are neither necessary nor cost-effective.
Br J Neurosurg, 31 (1).
pp. 50-53.
ISSN 1360-046X
https://doi.org/10.1080/02688697.2016.1233320
SGUL Authors: Pereira, Erlick Abilio Coelho
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Abstract
OBJECTIVES: Anterior cervical discectomy and fusion (ACDF) is a common operative treatment of compressive pathology of the cervical spinal cord, when caused by one or more degenerated intervertebral discs or related osteophytes. In addition to intra-operative radiographs to confirm spinal level before discectomy and implant position after insertion, traditional practice is to obtain post-operative antero-posterior and lateral plain radiographs (XR) before hospital discharge, despite a paucity of evidence supporting their benefit to patient care. Minimising unnecessary radiation to radiosensitive neck structures is desirable, and furthermore, with increasing financial pressure on healthcare resources, routine investigations should be clinically justified and evidence-based. We aim to compare the utility of routine post-operative cervical spine X-rays following ACDF. METHODS: We compare two groups of consecutive patients undergoing ACDF in a single UK neurosurgical centre. The first group (n = 109) received routine post-operative XR imaging, and the second group (n = 113) received radiographs only when clinically indicated. RESULTS: There were no differences in post-operative complication rates (4.6% vs. 5.3%), or requirement for further imaging or of further operative intervention (1.8% vs. 0.9%). The group that did not have routine post-operative radiographs had a significantly shorter stay in hospital (median two days vs. three days). There were no patients in either group where post-operative XR changed clinical management and mandated revision surgery or further imaging. All cases requiring surgery or further imaging were identified by clinical deterioration. CONCLUSIONS: We suggest that the practice of obtaining routine radiographs of the cervical spine following ACDF should be abandoned, unless there is a clear clinical indication.
Item Type: | Article | ||||||||
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Additional Information: | This is an Accepted Manuscript of an article published by Taylor & Francis in British Journal of Neurosurgery on 22nd September 2016, available online: http://www.tandfonline.com/10.1080/02688697.2016.1233320 | ||||||||
Keywords: | Anterior cervical discectomy and fusion, complication, post-operative radiograph, Anterior cervical discectomy and fusion, complication, post-operative radiograph, Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | Br J Neurosurg | ||||||||
ISSN: | 1360-046X | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Publisher's own licence | ||||||||
PubMed ID: | 27658985 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/108307 | ||||||||
Publisher's version: | https://doi.org/10.1080/02688697.2016.1233320 |
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