TY - JOUR
T1 - Revision Anterior Cervical Discectomy and Fusion and Revision Cervical Arthroplasty Are Associated with Similar Outcomes
T2 - Real-World Analysis from a National Quality Registry
AU - Tsai, Sung Huang Laurent
AU - Alvi, Mohammed Ali
AU - Tazyeen, Saema
AU - Yolcu, Yagiz
AU - Javeed, Saad
AU - Sebastian, Arjun
AU - Freedman, Brett A.
AU - Bydon, Mohamad
AU - Elder, Benjamin D.
N1 - Publisher Copyright:
© 2021. All Rights Reserved.
PY - 2021
Y1 - 2021
N2 - AIM: To utilize a national surgical quality registry to compare 30-day quality outcomes between repeat anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA). MATERIAL and METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant User Files (PUF) for the years 2005-2018 were queried for patients undergoing repeat ACDF and CDA using current procedural terminology (CPT) and International Classification of Disease (ICD)-9th version codes. We compared demographic and baseline clinical characteristics, operative characteristics, 30-day readmissions, reoperations, and complications between the two groups. We also performed multivariable analyses to assess the impact of the type of repeat procedure on outcomes of interest. RESULTS: A total of 3,957 patients were identified, of which 182 underwent revision/removal of arthroplasty, while 3,775 underwent revision or removal of fusion. Up to 4.6% of patients (n=179) in the repeat ACDF group had a complication, compared to 0.5% (n=1) in the CDA group. The 30-day readmission rate was found to be similar between the two groups (repeat-ACDF, 3.8% (n=145), vs. repeat-CDA, 2.2% (n=4); p=0.23). Similarly, 30-day reoperation rate was also not found to be different between the two groups (repeat-ACDF, 3.9% (n=149) vs. repeat-CDA, 2.7% (n=5); p=0.39). On multivariable analysis, removal or revision ACDF was found to be only significantly associated with an increased risk of 30-day complications (OR, 8.00; 95% CI, 1.07-59.79; p=0.04). CONCLUSION: Repeat ACDF or repeat CDA can be performed safely and are associated with optimal 30-day outcomes, comparable to those of index procedures. However, patients undergoing revision ACDF may be slightly more likely to have complications than those undergoing revision CDA.
AB - AIM: To utilize a national surgical quality registry to compare 30-day quality outcomes between repeat anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA). MATERIAL and METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant User Files (PUF) for the years 2005-2018 were queried for patients undergoing repeat ACDF and CDA using current procedural terminology (CPT) and International Classification of Disease (ICD)-9th version codes. We compared demographic and baseline clinical characteristics, operative characteristics, 30-day readmissions, reoperations, and complications between the two groups. We also performed multivariable analyses to assess the impact of the type of repeat procedure on outcomes of interest. RESULTS: A total of 3,957 patients were identified, of which 182 underwent revision/removal of arthroplasty, while 3,775 underwent revision or removal of fusion. Up to 4.6% of patients (n=179) in the repeat ACDF group had a complication, compared to 0.5% (n=1) in the CDA group. The 30-day readmission rate was found to be similar between the two groups (repeat-ACDF, 3.8% (n=145), vs. repeat-CDA, 2.2% (n=4); p=0.23). Similarly, 30-day reoperation rate was also not found to be different between the two groups (repeat-ACDF, 3.9% (n=149) vs. repeat-CDA, 2.7% (n=5); p=0.39). On multivariable analysis, removal or revision ACDF was found to be only significantly associated with an increased risk of 30-day complications (OR, 8.00; 95% CI, 1.07-59.79; p=0.04). CONCLUSION: Repeat ACDF or repeat CDA can be performed safely and are associated with optimal 30-day outcomes, comparable to those of index procedures. However, patients undergoing revision ACDF may be slightly more likely to have complications than those undergoing revision CDA.
KW - 30-day outcomes
KW - CDA
KW - Cervical disc arthroplasty
KW - Cervical disc replacement
KW - Cervical fusion
KW - Cervical spine
KW - NSQIP
KW - Outcomes
KW - Spine
KW - repeat ACDF
UR - http://www.scopus.com/inward/record.url?scp=85120065990&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120065990&partnerID=8YFLogxK
U2 - 10.5137/1019-5149.JTN.33270-20.4
DO - 10.5137/1019-5149.JTN.33270-20.4
M3 - Article
C2 - 34664693
AN - SCOPUS:85120065990
SN - 1019-5149
VL - 31
SP - 952
EP - 961
JO - Turkish Neurosurgery
JF - Turkish Neurosurgery
IS - 6
ER -