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Radiographs Unnecessary After Neurosurgical Procedure

Researchers argue against routine radiographs after single-level anterior cervical discectomy, fusion and plate placement

THURSDAY, Aug. 7 (HealthDay News) -- In patients who undergo single-level anterior cervical discectomy, fusion and plate placement (ACDFP), the routine administration of postoperative radiographs may be unnecessary because pseudarthrosis and construct failure rarely occur and patients with new symptoms are as likely to have either normal or abnormal radiographic findings, according to a report published in the August issue of the Journal of Neurosurgery: Spine.

Kene T. Ugokwe, M.D., of the Cleveland Clinic in Cleveland, Ohio, and colleagues reviewed the charts and radiographs of 53 patients who underwent a single-level ACDFP between Jan. 1, 2000 and Dec. 31, 2005.

The researchers found that 49 of the subjects showed postsurgical improvements in neck and arm pain, and/or neurological dysfunction, but that only five showed abnormal radiographic findings, and that no patients had repeat surgery based on radiograph findings.

"Routinely obtaining postoperative radiographs at regular intervals in asymptomatic patients following single-level ACDFP does not appear to be warranted," the authors conclude. "Fusion status is often difficult to determine with static radiographs, but the addition of flexion/extension films may aid in the determination of this status. Computed tomography scanning, even with an increased cost and radiation exposure to the patient, may be needed in those indeterminate cases."

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