TY - JOUR
T1 - Reoperation and Perioperative Complications after Surgical Treatment of Cervical Radiculopathy
T2 - A Comparison between Three Procedures
AU - Nayak, Rusheel
AU - Razzouk, Jacob
AU - Ramos, Omar
AU - Ruckle, David
AU - Chiu, Anthony
AU - Parel, Philip
AU - Stoll, William T.
AU - Patel, Shalin
AU - Thakkar, Savyasachi
AU - Danisa, Olumide A.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/2/15
Y1 - 2023/2/15
N2 - Study Design. A retrospective database study. Objective. The purpose of our study was to compare the perioperative complications and reoperation rates after anterior cervical discectomy and fusion (ACDF), cervical disk arthroplasty (CDA), and posterior cervical foraminotomy (PCF) in patients treated for cervical radiculopathy. Summary of Background Data. Cervical radiculopathy results from compression or irritation of nerve roots in the cervical spine. While most cervical radiculopathy is treated nonoperatively, ACDF, CDA, and PCF are the techniques most commonly used if operative intervention is indicated. There is limited research evaluating the perioperative complications of these surgical techniques. Materials and Methods. A retrospective review was performed using the PearlDiver Patient Record Database to identify cases of cervical radiculopathy that underwent ACDF, CDA, or PCF at one or two levels from 2007 to 2016. Perioperative complications and reoperations following each of the procedures were assessed. Results. During the study period, 25,051 patients underwent ACDF, 522 underwent CDA, and 3986 underwent PCF. After propensity score matching, each of the three groups consisted of 507 patients. Surgical site infection rates were highest after PCF (2.17%) compared with ACDF (0.20%) and CDA (0.59%) at 30 days and three months (P=0.003, P<0.001), respectively. New-onset cervicalgia was highest following ACDF (34.32%) and lowest after PCF (22.88%) at three and six months (P<0.001 and P=0.003), respectively. Revision surgeries were highest among those who underwent CDA (6.90%) versus ACDF (3.16%) and PCF (3.55%) at six months (P=0.007). Limb paralysis was significantly higher after PCF compared with CDA and ACDF at six months (P<0.017). Conclusions. The rate of surgical site infection was higher in PCF compared with ACDF and CDA. New-onset cervicalgia was higher after ACDF compared with PCF and CDA at short-term follow-up. Revision surgeries were highest among those undergoing CDA and lowest in those undergoing ACDF. Level of Evidence. 3.
AB - Study Design. A retrospective database study. Objective. The purpose of our study was to compare the perioperative complications and reoperation rates after anterior cervical discectomy and fusion (ACDF), cervical disk arthroplasty (CDA), and posterior cervical foraminotomy (PCF) in patients treated for cervical radiculopathy. Summary of Background Data. Cervical radiculopathy results from compression or irritation of nerve roots in the cervical spine. While most cervical radiculopathy is treated nonoperatively, ACDF, CDA, and PCF are the techniques most commonly used if operative intervention is indicated. There is limited research evaluating the perioperative complications of these surgical techniques. Materials and Methods. A retrospective review was performed using the PearlDiver Patient Record Database to identify cases of cervical radiculopathy that underwent ACDF, CDA, or PCF at one or two levels from 2007 to 2016. Perioperative complications and reoperations following each of the procedures were assessed. Results. During the study period, 25,051 patients underwent ACDF, 522 underwent CDA, and 3986 underwent PCF. After propensity score matching, each of the three groups consisted of 507 patients. Surgical site infection rates were highest after PCF (2.17%) compared with ACDF (0.20%) and CDA (0.59%) at 30 days and three months (P=0.003, P<0.001), respectively. New-onset cervicalgia was highest following ACDF (34.32%) and lowest after PCF (22.88%) at three and six months (P<0.001 and P=0.003), respectively. Revision surgeries were highest among those who underwent CDA (6.90%) versus ACDF (3.16%) and PCF (3.55%) at six months (P=0.007). Limb paralysis was significantly higher after PCF compared with CDA and ACDF at six months (P<0.017). Conclusions. The rate of surgical site infection was higher in PCF compared with ACDF and CDA. New-onset cervicalgia was higher after ACDF compared with PCF and CDA at short-term follow-up. Revision surgeries were highest among those undergoing CDA and lowest in those undergoing ACDF. Level of Evidence. 3.
KW - anterior cervical discectomy and fusion
KW - cervical disk arthroplasty
KW - cervical radiculopathy
KW - perioperative complication rates
KW - posterior cervical foraminotomy
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UR - http://www.scopus.com/inward/citedby.url?scp=85147036167&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000004506
DO - 10.1097/BRS.0000000000004506
M3 - Article
C2 - 36255369
AN - SCOPUS:85147036167
SN - 0362-2436
VL - 48
SP - 261
EP - 269
JO - Spine
JF - Spine
IS - 4
ER -