FACADE

FACADE is prospective, randomised non-inferiority trial comparing traditional overnight hospital surveillance to discharge on the day of the surgery in patients who have undergone anterior cervical decompression and fusion.

Why is this trial needed?

Cervical radiculopathy syndrome (CRS) or radiating arm pain caused by cervical nerve root irritation is a common complaint in otherwise healthy working-aged population with an annual incidence of approximately 0.8 per 1000 inhabitants. Conservative treatment is a viable alternative for the majority of CRS patients, as their symptoms are periodic and improve with time. However, a considerable proportion of CRS patients experience persisting symptoms severe enough to justify neurosurgical intervention.

Herniated Disc in the Neck

To date, no randomised trial has compared outpatient to inpatient care in patients who have undergone ACDF, particularly with a special emphasis on the patients’ immediate perceptions of the care given and their self-perceived ability to return to normal daily activities and work. We will conduct a pragmatic, randomized, non-inferiority trial comparing the traditional hospital surveillance (inpatient) to outpatient care (same day discharge, within 6-8 hours after procedure) for patients undergoing ACDF procedure.

What is the primary objective of the FACADE trial?

We hypothesize that with the current technique of performing ACDF, the outcome of patients in the outpatient care group is not worse than in the conventional postoperative strategy (inpatient care). We further hypothesize that patients treated on an outpatient basis would perceive themselves to be less disabled, subsequently encouraging them to return more quickly to their normal daily activities and work.

Where are we now?

The trial has started in the beginning of June. Manuscript for protocol has been sent to be evaluated.

Principal investigators

Kimmo Lönnrot

MD, PhD, Neurosurgeon, Senior researcher

Teppo Järvinen

Professor, Head

Simo Taimela

Adjunct professor, Research director

Project team

Pirjo Toivonen, Project coordinator

Marja Silvasti-Lundell, Jarno Satopää, Johannes Förster, Anniina Koski-Palken, Janek Frantzen, Ville Leinonen, Behnam Rezai-Jahromi

Contributors

Operating surgeons:

Miikka Korja, Jussi Antinheimo, Leena Kivipelto, Matti Seppälä, Kimmo Lönnrot