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Anterior cervical discectomy and fusion versus cervical disc arthroplasty: an epidemiological review of 433,660 surgical patients from 2011 to 2021.
Singh, Manjot; Balmaceno-Criss, Mariah; Anderson, George; Parhar, Kanwar; Daher, Mohammad; Gregorczyk, Jerzy; Liu, Jonathan; McDonald, Christopher L; Diebo, Bassel G; Daniels, Alan H.
Afiliación
  • Singh M; Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA.
  • Balmaceno-Criss M; Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
  • Anderson G; Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA.
  • Parhar K; Elson S. Floyd College of Medicine, Washington State University, 412 E Spokane Falls Blvd, Spokane, WA 99202, USA.
  • Daher M; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
  • Gregorczyk J; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
  • Liu J; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
  • McDonald CL; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
  • Diebo BG; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
  • Daniels AH; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA. Electronic address: Alan_daniels@brown.edu.
Spine J ; 24(8): 1342-1351, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38408519
ABSTRACT
BACKGROUND CONTEXT Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are commonly performed operations to address cervical radiculopathy and myelopathy. Trends in utilization and revision surgery rates warrant investigation.

PURPOSE:

To explore the epidemiology, postoperative complications, and reoperation rates of ACDF and CDA.

DESIGN:

Retrospective cohort study. PATIENT SAMPLE A total of 433,660 patients who underwent ACDF or CDA between 2011 and 2021 were included in this study. OUTCOME

MEASURES:

The following data were observed for all cases patient demographics, complications, and revisions.

METHODS:

The PearlDiver database was queried to identify patients who underwent ACDF and CDA between 2011 and 2021. Epidemiological analyses were performed to examine trends in cervical procedure utilization by age group and year. After matching by age, sex, Charlson Comorbidity Index (CCI), levels of operation, and reason for surgery, the early postoperative (2-week), short-term (2-year), and long-term (5-year) complications of both cervical procedures were examined.

RESULTS:

In total, 404,195 ACDF and 29,465 CDA patients were included. ACDF utilization rose by 25.25% between 2011 and 2014 while CDA utilization rose by 654.24% between 2011-2019 followed by relative plateauing in both procedures. Mann-Kendall trend test confirmed a significant but small rise in ACDF and large rise in CDA procedures from 2011 to 2021 (p<.001). After matching, ACDF and CDA had an overall complication rate of 12.20% and 8.77%, respectively, with the most common complications being subsequent anterior revision (4.96% and 3.35%) and dysphagia (3.70% and 2.98%). The ACDF cohort, especially multilevel ACDF patients, generally had more complications and higher revision rates than the CDA cohort (p<.05).

CONCLUSIONS:

While ACDF utilization has plateaued since 2014, CDA rates have risen by a staggering 654.24% over the past decade. ACDF and CDA complication and revision rates were relatively low in comparison to previously published values, with significantly lower rates in CDA. Although a lack of radiographic data in this study limits its power to recommend either procedure for individual patients with cervical radiculopathy or myelopathy, CDA may be associated with minor improvement in the complication and revision profile.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Fusión Vertebral / Vértebras Cervicales / Discectomía Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Fusión Vertebral / Vértebras Cervicales / Discectomía Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos