FACADE trial results published in JAMA Network Open

We are pleased to announce that the results of the FACADE trial (Finnish Trial on Practices of Anterior Cervical Decompression and Fusion) have now been published in JAMA Network Open.

The trial compared ambulatory care (same-day discharge) with overnight hospital surveillance after anterior cervical decompression and fusion (ACDF) in adults with cervical radiculopathy, one of the most common neurosurgical procedures.

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Key findings

·      At 6 months after surgery, functional recovery (measured by the Neck Disability Index) was non inferior in the ambulatory group compared with the overnight group.

·      Secondary outcomes (pain, quality of life, return to work, satisfaction) showed no meaningful differences between groups.

·      There were no increased serious adverse events in the ambulatory care group.

These results provide the first level I evidence globally comparing ambulatory care to inpatient surveillance after ACDF and support the feasibility and safety of early discharge in appropriately selected patients.

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Read the full article in JAMANetwork Open

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Interview with the lead investigator, Dr. Kimmo Lönnrot

Q: When did the FACADE trial begin, and where did the idea come from?

A: We started planning in 2015 and began recruitment in 2017. ACDF is one of the most commonly performed neurosurgical procedures, but while drafting the protocol we came across a systematic review showing how little randomized evidence exists in spinal surgery overall. That convinced us this was a study worth doing.

Q: How was the trial journey?

A: Like all RCTs, it sometimes felt like a never-ending journey. Recruitment took years, but eventually we reached our target, and at the end of the tunnel, it wasn’t a train this time! After that came data curation, statistical analyses, and manuscript preparation. Aiming high meant the publication process took time, but in the end, we’re delighted that JAMA Network Open accepted our work.

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A note of gratitude

With FACADE, Kimmo brought a neurosurgical dimension into FICEBO. Together with Rahul and Pihla, this collaboration has now produced two major randomized trial publications (FAÇADE and FINISH) in 2024 alone.

We’re deeply grateful to Kimmo for his exceptional leadership and project coordination, which has strengthened FICEBO’s research portfolio in an entirely new field.

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