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Single-level posterior cervical foraminotomy associated with increased incidence of early postoperative wound infection rates relative to anterior cervical discectomy with fusion and cervical disc arthroplasty.

作者信息

Ng Mitchell K, Emara Ahmed K, Rajan Prashant V, Grits Daniel, Pathak Neil, Ng Kenneth, Pelle Dominic W, Razi Afshin

机构信息

Department of Orthopaedic Surgery, Maimonides Clinical Center, New York, NY, USA.

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

J Spine Surg. 2023 Mar 30;9(1):54-64. doi: 10.21037/jss-21-39. Epub 2022 Jan 4.


DOI:10.21037/jss-21-39
PMID:37038421
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10082422/
Abstract

BACKGROUND: To date, there are no studies comparing perioperative outcomes of cervical radiculopathy patients managed by anterior cervical discectomy with fusion (ACDF), cervical disc arthroplasty (CDA), or posterior cervical foraminotomy (PCF). To assess if there were differences in perioperative outcomes between cervical radiculopathy patients who can be appropriately treated with ACDF, CDA, or PCF. METHODS: Patients diagnosed with cervical radiculopathy who underwent a single-level ACDF, CDA, or PCF between 2012 and 2019 were retrospectively identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database using current procedural terminology (CPT) codes. Patients were subsequently stratified into those who underwent ACDF, CDA, or PCF, and propensity score-matched to adjust for differences in patient demographics/characteristics. Differences were assessed in terms of operative time, healthcare utilization metrics (reoperations, readmissions, lengths-of-stay), as well as medical and surgical complications. RESULTS: A total of 18,614 cervical radiculopathy patients undergoing surgery were identified (ACDF: n=15,862; CDA: n=1,731; PCF: n=1,021). After 1:1 propensity score matching (n=535 each), there were no differences in characteristics in patients undergoing ACDF, CDA, or PCF (P>0.05). PCF patients had statistically higher rates of reoperation (2.1%) than ACDF (0.4%), CDA (0.6%) patients (P=0.010). PCF patients also experienced higher rates of superficial infection (P=0.001), and deep infection (P=0.007), relative to ACDF and CDA patients. There were no other significant differences in medical/surgical complications between the ACDF, CDA, or PCF patients. CONCLUSIONS: Cervical radiculopathy patients undergoing PCF are associated with higher rates of perioperative infection and overall reoperation than ACDF or CDA. Further research is required to elucidate the mechanism behind this association.

摘要

相似文献

[1]
Single-level posterior cervical foraminotomy associated with increased incidence of early postoperative wound infection rates relative to anterior cervical discectomy with fusion and cervical disc arthroplasty.

J Spine Surg. 2023-3-30

[2]
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.

Global Spine J. 2024-4

[3]
Reoperation and Perioperative Complications After Surgical Treatment of Cervical Radiculopathy: A Comparison Between Three Procedures.

Spine (Phila Pa 1976). 2023-2-15

[4]
Surgical Treatment of Single Level Cervical Radiculopathy: A Comparison of Anterior Cervical Decompression and Fusion (ACDF) Versus Cervical Disk Arthroplasty (CDA) Versus Posterior Cervical Foraminotomy (PCF).

Clin Spine Surg. 2022-5-1

[5]
Reoperation rates after anterior cervical discectomy and fusion versus posterior cervical foraminotomy: a propensity-matched analysis.

Spine J. 2015-6-1

[6]
Rates of anterior cervical discectomy and fusion after initial posterior cervical foraminotomy.

Spine J. 2015-5-1

[7]
Minimally Invasive Posterior Cervical Foraminotomy Versus Anterior Cervical Fusion and Arthroplasty: Systematic Review and Meta-Analysis.

Global Spine J. 2022-9

[8]
Comparison of Single-Level Posterior Cervical Foraminotomy to Anterior Cervical Discectomy and Fusion for Radiculopathy.

Int J Spine Surg. 2023-6

[9]
Comparison of Anterior Cervical Discectomy and Fusion to Posterior Cervical Foraminotomy for Cervical Radiculopathy: Utilization, Costs, and Adverse Events 2003 to 2014.

Neurosurgery. 2019-2-1

[10]
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引用本文的文献

[1]
Presentation and management of infection in total disc replacement: A review.

N Am Spine Soc J. 2024-3-6

[2]
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.

Global Spine J. 2024-4

本文引用的文献

[1]
Comparison of Anterior Cervical Discectomy and Fusion to Posterior Cervical Foraminotomy for Cervical Radiculopathy: Utilization, Costs, and Adverse Events 2003 to 2014.

Neurosurgery. 2019-2-1

[2]
Comparison of Anterior Cervical Discectomy and Fusion versus Posterior Cervical Foraminotomy in the Treatment of Cervical Radiculopathy: A Systematic Review.

Orthop Surg. 2016-11

[3]
Cervical radiculopathy.

Curr Rev Musculoskelet Med. 2016-9

[4]
An Updated Meta-Analysis Comparing Artificial Cervical Disc Arthroplasty (CDA) Versus Anterior Cervical Discectomy and Fusion (ACDF) for the Treatment of Cervical Degenerative Disc Disease (CDDD).

Spine (Phila Pa 1976). 2015-12

[5]
Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment.

J Spinal Disord Tech. 2015-6

[6]
Pseudoarthrosis rates in anterior cervical discectomy and fusion: a meta-analysis.

Spine J. 2015-9-1

[7]
Minimum 4-year outcomes of cervical total disc arthroplasty versus fusion: a meta-analysis based on prospective randomized controlled trials.

Medicine (Baltimore). 2015-4

[8]
Reoperation rates after anterior cervical discectomy and fusion versus posterior cervical foraminotomy: a propensity-matched analysis.

Spine J. 2015-6-1

[9]
The duration of symptoms and clinical outcomes in patients undergoing anterior cervical discectomy and fusion for degenerative disc disease and radiculopathy.

Spine J. 2015-3-1

[10]
Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases.

J Neurosurg Spine. 2014-8-15

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