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Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

STUDY DESIGN: Retrospective comparative study. OBJECTIVES: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion,...

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Autores principales: Mesregah, Mohamed Kamal, Formanek, Blake, Liu, John C., Buser, Zorica, Wang, Jeffrey C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972283/
https://www.ncbi.nlm.nih.gov/pubmed/33709809
http://dx.doi.org/10.1177/2192568221998306
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author Mesregah, Mohamed Kamal
Formanek, Blake
Liu, John C.
Buser, Zorica
Wang, Jeffrey C.
author_facet Mesregah, Mohamed Kamal
Formanek, Blake
Liu, John C.
Buser, Zorica
Wang, Jeffrey C.
author_sort Mesregah, Mohamed Kamal
collection PubMed
description STUDY DESIGN: Retrospective comparative study. OBJECTIVES: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty. METHODS: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level. RESULTS: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001. CONCLUSIONS: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion.
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spelling pubmed-99722832023-03-01 Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures Mesregah, Mohamed Kamal Formanek, Blake Liu, John C. Buser, Zorica Wang, Jeffrey C. Global Spine J Original Articles STUDY DESIGN: Retrospective comparative study. OBJECTIVES: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty. METHODS: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level. RESULTS: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001. CONCLUSIONS: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion. SAGE Publications 2021-03-12 2023-03 /pmc/articles/PMC9972283/ /pubmed/33709809 http://dx.doi.org/10.1177/2192568221998306 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
Mesregah, Mohamed Kamal
Formanek, Blake
Liu, John C.
Buser, Zorica
Wang, Jeffrey C.
Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures
title Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures
title_full Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures
title_fullStr Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures
title_full_unstemmed Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures
title_short Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures
title_sort perioperative complications of surgery for degenerative cervical myelopathy: a comparison between 3 procedures
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972283/
https://www.ncbi.nlm.nih.gov/pubmed/33709809
http://dx.doi.org/10.1177/2192568221998306
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