Gupta Puneet, Hassan Fthimnir M, Thomas George M, Lombardi Joseph M, Sardar Zeeshan M
Department of Orthopaedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Department of Orthopaedic Surgery, George Washington University, Washington, DC, USA.
Global Spine J. 2024 May;14(4):1257-1268. doi: 10.1177/21925682221139436. Epub 2022 Nov 9.
Retrospective, propensity-matched analysis.
Cervical disc arthroplasty (CDA) is being increasingly utilized for cervical disc generation. Surgeon specialty has been shown to influence the risk for postoperative complications in spine surgery, but this has not yet been explored for CDA. Thus, the purpose of this study is to determine whether there is any difference in 30-day complications between patients undergoing single-level CDA by neurosurgeons vs by orthopaedic surgeons.
A retrospective, 1:1 propensity score matched analysis was performed using the NSQIP database from 2015 to 2020. Patient demographics, operative characteristics, and postoperative complications were recorded. Independent multivariate logistic regression models were constructed using the propensity-matched dataset to assess surgical specialty influence on any complication, any site complication, any operative infection, and any medical complications.
3179 single-level CDAs (28.8% orthopaedic surgery patients, 71.2% neurosurgery patients) were identified that met the inclusion criteria. Well-matched cohorts of 916 patients each were generated. After controlling for all possible confounders, orthopedic surgery specialty was not associated with a higher odds for any complication (OR: .87, 95% CI: .35 - 2.20, = .7696), any site complication (OR: .32, 95% CI: .08 - 1.32, = .1359), any operative infection (OR: .31, 95% CI: .07 - 1.34), = .1172), nor any medical complication (OR: 2.11, 95% CI: .62 - 7.20, = .2311) vs neurosurgery.
This is the first propensity-matched analysis to show that spine surgeon specialty does not influence the risk for any complication, any site complication, any operative infection, nor any medical complication following single-level CDA within the first 30 days after surgery.
回顾性、倾向匹配分析。
颈椎间盘置换术(CDA)在颈椎间盘疾病治疗中的应用日益广泛。已有研究表明外科医生的专业会影响脊柱手术术后并发症的风险,但CDA手术尚未有相关探索。因此,本研究的目的是确定神经外科医生与骨科医生进行单节段CDA手术的患者在30天并发症方面是否存在差异。
使用2015年至2020年的NSQIP数据库进行回顾性1:1倾向评分匹配分析。记录患者的人口统计学资料、手术特征和术后并发症。使用倾向匹配数据集构建独立的多变量逻辑回归模型,以评估手术专业对任何并发症、任何部位并发症、任何手术感染和任何医疗并发症的影响。
共识别出3179例符合纳入标准的单节段CDA手术(28.8%为骨科手术患者,71.2%为神经外科手术患者)。生成了每组916例患者的匹配良好队列。在控制所有可能的混杂因素后,骨科手术专业与任何并发症(OR:0.87,95%CI:0.35 - 2.20,P = 0.7696)、任何部位并发症(OR:0.32,95%CI:0.08 - 1.32,P = 0.1359)、任何手术感染(OR:0.31,95%CI:0.07 - 1.34,P = 0.1172)或任何医疗并发症(OR:2.11,95%CI:0.62 - 7.20,P = 0.2311)的较高发生率均无关,与神经外科手术相比无差异。
这是首次进行的倾向匹配分析,表明脊柱外科医生的专业不会影响单节段CDA手术后30天内任何并发症、任何部位并发症、任何手术感染或任何医疗并发症的风险。