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
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 Quali...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2020-12-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-2040134-067.pdf |
| _version_ | 1797333304392810496 |
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| author | Anoop R. Galivanche Raj Gala Preetpaul S. Bagi Arianne J. Boylan Christopher M. Dussik Pedro D. Coutinho Jonathan N. Grauer Arya G. Varthi |
| author_facet | Anoop R. Galivanche Raj Gala Preetpaul S. Bagi Arianne J. Boylan Christopher M. Dussik Pedro D. Coutinho Jonathan N. Grauer Arya G. Varthi |
| author_sort | Anoop R. Galivanche |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T08:01:50Z |
| format | Article |
| id | doaj.art-a68029a076924535b545b5da519abc14 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:01:50Z |
| publishDate | 2020-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-a68029a076924535b545b5da519abc142024-02-02T12:05:03ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912020-12-0117487187810.14245/ns.2040134.0671092Perioperative 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 AnalysisAnoop R. Galivanche0Raj Gala1Preetpaul S. Bagi2Arianne J. Boylan3Christopher M. Dussik4Pedro D. Coutinho5Jonathan N. Grauer6Arya G. Varthi7 Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USAObjective 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.http://www.e-neurospine.org/upload/pdf/ns-2040134-067.pdfanterior cervical discectomy and fusionanterior cervical corpectomy and fusioncorpectomydiscectomyfusion |
| spellingShingle | Anoop R. Galivanche Raj Gala Preetpaul S. Bagi Arianne J. Boylan Christopher M. Dussik Pedro D. Coutinho Jonathan N. Grauer Arya G. Varthi 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 Neurospine anterior cervical discectomy and fusion anterior cervical corpectomy and fusion corpectomy discectomy fusion |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | anterior cervical discectomy and fusion anterior cervical corpectomy and fusion corpectomy discectomy fusion |
| url | http://www.e-neurospine.org/upload/pdf/ns-2040134-067.pdf |
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