Loading...
Please wait, while we are loading the content...
Similar Documents
Multi-Level Posterior Cervical Foraminotomy Associated With Increased Post-operative Infection Rates and Overall Re-Operation Relative to Anterior Cervical Discectomy With Fusion or Cervical Disc Arthroplasty
| Content Provider | SAGE Publishing |
|---|---|
| Author | Ng, Mitchell K. Kobryn, Andriy Baidya, Joydeep Nian, Patrick Emara, Ahmed K. Ahn, Nicholas U. Houten, John K. Saleh, Ahmed Razi, Afshin E. |
| Copyright Year | 2022 |
| Abstract | Study DesignRetrospective Cohort StudyObjectiveCervical radiculopathy meeting operative criteria has traditionally been managed using anterior cervical discectomy and fusion (ACDF). However, cervical disc arthroplasty (CDA) and posterior cervical foraminotomy (PCF) are also reasonable options. This study aimed to assess differences in postoperative outcomes among patients undergoing multi-level ACDF, CDA, or PCF comparing medical/surgical complications and healthcare utilization parameters.MethodsPatients who underwent multi-level ACDF, CDA, or PCF between 2012 and 2019 were identified from the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. Patients were stratified based on procedure type and propensity score matched to resolve baseline differences. ANOVA was performed to identify differences in medical complications, surgical complications, and healthcare utilization metrics.ResultsA total of 31 344 patients who underwent an eligible procedure were identified (ACDF: n = 28 089, CDA: n = 1748, PCF: n = 1507), and 684 patients remained in each group following propensity score matching. Patients undergoing multi-level PCF were found to experience longer lengths of hospital stay (PCF: 1.67 ± 1.61 days, ACDF: 1.50 ± 1.32 days, CDA: 1.27 ± 1.05 days, P < .001), higher rates of reoperation (PCF: 3.2%, ACDF: 1.0%, CDA: .4%, P = .020), superficial infection (PCF: 1.3%, ACDF: .3%, CDA: .1%, P = .008) and deep infection (PCF: 1.2%, ACDF: 0%, CDA: 0%, P < .001). There were no outcome differences between multi-level ACDF and CDA.ConclusionsPatients undergoing multi-level PCF were at increased risk for longer hospital stay, re-operation, and infection relative to those undergoing ACDF and CDA. Future research should aim to uncover the precise mechanisms underlying these complications, as well as analyze long term outcomes.Level of EvidenceIII |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/21925682221124530?download=true |
| ISSN | 21925682 |
| Journal | Global Spine Journal (GSJ) |
| e-ISSN | 21925690 |
| DOI | 10.1177/21925682221124530 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2022-09-02 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2022 |
| Subject Keyword | cervical disc arthroplasty anterior cervical discectomy and fusion radiculopathy posterior cervical foraminotomy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Neurology (clinical) Surgery |
