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To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy

STUDY DESIGN: Retrospective cohort study OBJECTIVES: To evaluate the effect of caudal instrumentation level on revision rates following posterior cervical laminectomy and fusion. METHODS: A retrospective review of a prospectively collected database was performed. Minimum follow-up was one year. Pati...

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Autores principales: Couch, Brandon K., Patel, Stuti S., Talentino, Spencer E., Buldo-Licciardi, Michael, Evashwick-Rogler, Thomas W., Oyekan, Anthony A., Gannon, Emmett J., Shaw, Jeremy D., Donaldson, William F., Lee, Joon Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538346/
https://www.ncbi.nlm.nih.gov/pubmed/35285337
http://dx.doi.org/10.1177/21925682221083926
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author Couch, Brandon K.
Patel, Stuti S.
Talentino, Spencer E.
Buldo-Licciardi, Michael
Evashwick-Rogler, Thomas W.
Oyekan, Anthony A.
Gannon, Emmett J.
Shaw, Jeremy D.
Donaldson, William F.
Lee, Joon Y.
author_facet Couch, Brandon K.
Patel, Stuti S.
Talentino, Spencer E.
Buldo-Licciardi, Michael
Evashwick-Rogler, Thomas W.
Oyekan, Anthony A.
Gannon, Emmett J.
Shaw, Jeremy D.
Donaldson, William F.
Lee, Joon Y.
author_sort Couch, Brandon K.
collection PubMed
description STUDY DESIGN: Retrospective cohort study OBJECTIVES: To evaluate the effect of caudal instrumentation level on revision rates following posterior cervical laminectomy and fusion. METHODS: A retrospective review of a prospectively collected database was performed. Minimum follow-up was one year. Patients were divided into two groups based on the caudal level of their index fusion construct (Group 1-cervical and Group 2- thoracic). Reoperation rates were compared between the two groups, and preoperative demographics and radiographic parameters were compared between patients who required revision and those who did not. Multivariate binomial regression analysis was performed to determine independent risk factors for revision surgery. RESULTS: One hundred thirty-seven (137/204) patients received fusion constructs that terminated at C7 (Group 1), while 67 (67/204) received fusion constructs that terminated at T1 or T2 (Group 2). The revision rate was 8.33% in the combined cohort, 7.3% in Group 1, and 10.4% in Group 2. There was no significant difference in revision rates between the 2 groups (P = .43). Multivariate regression analysis did not identify any independent risk factors for revision surgery. CONCLUSION: This study shows no evidence of increased risk of revision in patients with fusion constructs terminating in the cervical spine when compared to patients with constructs crossing the cervicothoracic junction. These findings support terminating the fusion construct proximal to the cervicothoracic junction when indicated. LEVEL OF EVIDENCE: III
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spelling pubmed-105383462023-09-29 To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy Couch, Brandon K. Patel, Stuti S. Talentino, Spencer E. Buldo-Licciardi, Michael Evashwick-Rogler, Thomas W. Oyekan, Anthony A. Gannon, Emmett J. Shaw, Jeremy D. Donaldson, William F. Lee, Joon Y. Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study OBJECTIVES: To evaluate the effect of caudal instrumentation level on revision rates following posterior cervical laminectomy and fusion. METHODS: A retrospective review of a prospectively collected database was performed. Minimum follow-up was one year. Patients were divided into two groups based on the caudal level of their index fusion construct (Group 1-cervical and Group 2- thoracic). Reoperation rates were compared between the two groups, and preoperative demographics and radiographic parameters were compared between patients who required revision and those who did not. Multivariate binomial regression analysis was performed to determine independent risk factors for revision surgery. RESULTS: One hundred thirty-seven (137/204) patients received fusion constructs that terminated at C7 (Group 1), while 67 (67/204) received fusion constructs that terminated at T1 or T2 (Group 2). The revision rate was 8.33% in the combined cohort, 7.3% in Group 1, and 10.4% in Group 2. There was no significant difference in revision rates between the 2 groups (P = .43). Multivariate regression analysis did not identify any independent risk factors for revision surgery. CONCLUSION: This study shows no evidence of increased risk of revision in patients with fusion constructs terminating in the cervical spine when compared to patients with constructs crossing the cervicothoracic junction. These findings support terminating the fusion construct proximal to the cervicothoracic junction when indicated. LEVEL OF EVIDENCE: III SAGE Publications 2022-03-12 2023-10 /pmc/articles/PMC10538346/ /pubmed/35285337 http://dx.doi.org/10.1177/21925682221083926 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Couch, Brandon K.
Patel, Stuti S.
Talentino, Spencer E.
Buldo-Licciardi, Michael
Evashwick-Rogler, Thomas W.
Oyekan, Anthony A.
Gannon, Emmett J.
Shaw, Jeremy D.
Donaldson, William F.
Lee, Joon Y.
To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy
title To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy
title_full To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy
title_fullStr To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy
title_full_unstemmed To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy
title_short To Cross the Cervicothoracic Junction? Terminating Posterior Cervical Fusion Constructs Proximal to the Cervicothoracic Junction Does Not Impart Increased Risk of Reoperation in Patients With Cervical Spondylotic Myelopathy
title_sort to cross the cervicothoracic junction? terminating posterior cervical fusion constructs proximal to the cervicothoracic junction does not impart increased risk of reoperation in patients with cervical spondylotic myelopathy
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538346/
https://www.ncbi.nlm.nih.gov/pubmed/35285337
http://dx.doi.org/10.1177/21925682221083926
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