Patient-Centered outcomes and complication profiles of anterior versus posterior fixation in subaxial cervical facet dislocation: A comparative study.

Abstract

Objective: To compare anterior cervical discectomy and fusion (ACDF) and lateral mass screw (LMS) fixation for subaxial cervical facet dislocation such as complications, patient satisfaction, and recovery time. Study Design: Prospective Comparative study. Setting: Ghurki Trust Teaching Hospital. Period: March 2023 to December 2024. Methods: We prospectively analyzed 60 patients diagnosed with traumatic subaxial cervical facet dislocation and treated surgically. Based on the surgical approach, patients were divided into two groups: 32 underwent anterior cervical discectomy and fusion (ACDF) and 28 underwent lateral mass screw (LMS) fixation. Outcomes assessed included surgical complications, operative duration, hospital stay, time to return to work, postoperative pain (VAS), and patient satisfaction (Likert scale). Results: ACDF patients had significantly shorter operative times than LMS (88.20 ± 10.29 minutes vs. 102.14 ± 13.33 minutes, p < 0.01), a faster return to work (6.1 ± 1.4 weeks vs. 8.2 ± 1.9 weeks, p < 0.01).. Dysphagia was observed in 16% of patients in the ACDF group (5 out of 32), while hardware-related complications occurred in 7.1% of LMS cases (2 out of 28). Conclusion: ACDF shows superior outcomes in operative efficiency, early functional recovery, and patient-reported satisfaction, though with a higher risk of transient dysphagia. LMS remains a viable alternative when posterior stabilization is prioritized. These findings support a patient-centered approach in surgical decision-making.