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Perioperative Outcomes in 17,947 Patients Undergoing 2-Level Anterior Cervical Discectomy and Fusion Versus 1-Level Anterior Cervical Corpectomy for Treatment of Cervical Degenerative Conditions: A Propensity Score Matched National Surgical Quality Improvement Program Analysis.

作者信息

Galivanche Anoop R, Gala Raj, Bagi Preetpaul S, Boylan Arianne J, Dussik Christopher M, Coutinho Pedro D, Grauer Jonathan N, Varthi Arya G

机构信息

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA.

Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.

出版信息

Neurospine. 2020 Dec;17(4):871-878. doi: 10.14245/ns.2040134.067. Epub 2020 Dec 31.


DOI:10.14245/ns.2040134.067
PMID:33401865
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7788425/
Abstract

OBJECTIVE: To compare the perioperative morbidity of 2-level anterior cervical discectomy and fusion (ACDF) with that of 1-level anterior cervical corpectomy and fusion (ACCF) for the treatment of cervical degenerative conditions. METHODS: A retrospective study of the 2005-2016 National Surgical Quality Improvement Program database for patients undergoing 2-level ACDF and 1-level ACCF was performed. Patient data included: age, sex, body mass index (BMI), functional status, and American Society of Anesthesiologists (ASA) physical status (PS) classification. Hospital data included: operative time and length of hospital stay (LOS). Thirty-day outcome data included: any, serious, and minor adverse events, return to the operating room, readmission, and mortality. After propensity matching for age, sex, ASA PS classification, functional status, and BMI, multivariate logistic regression analysis was used to compare outcomes between the 2 propensity-matched subcohorts. Finally, multivariate logistic regression that additionally controlled for operative time was performed to compare the 2 propensity-matched subcohorts. RESULTS: A total of 17,497 cases were identified, with 90.20% undergoing 2-level ACDF and 9.80% undergoing 1-level ACCF. Patients undergoing 2-level ACDF were younger, more likely to be female, had higher functional status, and had shorter operative time and LOS (p < 0.001). After propensity score matching, cases undergoing 1-level ACCF had a statistically significant higher rate of serious adverse events (p = 0.005). This difference was no longer significant after controlling for operative time. CONCLUSION: While there was noted to be additional morbidity in 1-level ACCF cases relative to 2-level ACDF cases, the lack of difference once controlling for the surgical time supports using the procedure that best accomplishes the surgical objectives.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c3/7788425/17ce2ee5b455/ns-2040134-067f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c3/7788425/d7eebfa8ef7f/ns-2040134-067f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c3/7788425/17ce2ee5b455/ns-2040134-067f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c3/7788425/d7eebfa8ef7f/ns-2040134-067f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c3/7788425/17ce2ee5b455/ns-2040134-067f2.jpg

相似文献

[1]
Perioperative Outcomes in 17,947 Patients Undergoing 2-Level Anterior Cervical Discectomy and Fusion Versus 1-Level Anterior Cervical Corpectomy for Treatment of Cervical Degenerative Conditions: A Propensity Score Matched National Surgical Quality Improvement Program Analysis.

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[2]
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[4]
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[5]
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[9]
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[10]
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[6]
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[7]
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[8]
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Spine Deform. 2023-3

[9]
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[10]
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本文引用的文献

[1]
Anterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations.

Neurospine. 2019-9

[2]
Value of Surgery and Nonsurgical Approaches for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations.

Neurospine. 2019-9

[3]
Cervical Spondylotic Myelopathy: Natural Course and the Value of Diagnostic Techniques -WFNS Spine Committee Recommendations.

Neurospine. 2019-9

[4]
Trends in the Treatment of Single and Multilevel Cervical Stenosis: A Review of the American Board of Orthopaedic Surgery Database.

J Bone Joint Surg Am. 2017-9-20

[5]
Double-adjustment in propensity score matching analysis: choosing a threshold for considering residual imbalance.

BMC Med Res Methodol. 2017-4-28

[6]
Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data.

Clin Orthop Relat Res. 2017-12

[7]
Anterior cervical discectomy and fusion may be more effective than anterior cervical corpectomy and fusion for the treatment of cervical spondylotic myelopathy.

BMC Musculoskelet Disord. 2015-2-13

[8]
Variations in data collection methods between national databases affect study results: a comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures.

J Bone Joint Surg Am. 2014-12-3

[9]
Double propensity-score adjustment: A solution to design bias or bias due to incomplete matching.

Stat Methods Med Res. 2017-2

[10]
Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009.

Spine (Phila Pa 1976). 2013-6-15

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