From the Guidelines
An anterior cervical discectomy typically takes between 1 to 3 hours to complete, depending on the complexity of the case and whether fusion is performed. The procedure involves making a small incision in the front of the neck, moving aside soft tissues to access the spine, removing the damaged disc, and potentially placing bone graft material and hardware for fusion 1. Simple single-level discectomies without fusion may be on the shorter end of the timeframe, while multi-level procedures or those requiring more extensive reconstruction can take longer. Some key factors affecting surgical duration include:
- The patient's anatomy
- The surgeon's experience
- Whether there are complications during the procedure The operating time does not include pre-operative preparation or post-operative recovery in the surgical suite, which can add another 1-2 hours to the total time the patient spends in the operating room area. Patients should plan for spending most of the day at the hospital on the day of surgery, even though the actual procedure itself may be relatively brief. It's worth noting that the use of autologous bone graft material, which can be harvested from the iliac crest or the ribs, is probably the best option whenever possible, as it provides a durable and physiologically dynamic support system that both protects the neural structures and decreases mechanical pain 1.
From the Research
Operative Time for Anterior Cervical Discectomy
- The operative time for an anterior cervical discectomy can vary, but studies suggest that prolonged operative times are associated with adverse postoperative outcomes 2.
- A study analyzing 24,593 cases of single-level anterior cervical discectomy and fusion found that operative times greater than 91 minutes may carry higher odds of postoperative complications 2.
- The same study found that the odds of length of stay >2 days, non-home discharge disposition, reoperation, and bleeding requiring transfusion events began to rise, starting at 94,91.6,91.6, and 93.3 minutes of operative time, respectively 2.
Factors Affecting Operative Time
- The complexity of the procedure, the number of levels being operated on, and the surgeon's experience can all impact the operative time 3, 4.
- A study on 3-level microsurgical anterior cervical discectomy and fusion found that the procedure can be safely performed with a relatively short operative time, allowing for discharge on the first postoperative day 4.
Discharge Time and Operative Time
- A study found that patients undergoing anterior cervical discectomy and fusion later in the day are at a higher risk for staying overnight than those who have the first surgery of the day 5.
- The same study suggested that performing anterior cervical discectomy and fusion early in the day may result in a greater likelihood of same-day discharge, eliminating the increased resource utilization associated with an overnight hospital stay 5.