Reoperation and Perioperative Complications After Surgical Treatment of Cervical Radiculopathy: A Comparison Between Three Procedures.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7610646 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1159 (Electronic) Linking ISSN: 03622436 NLM ISO Abbreviation: Spine (Phila Pa 1976) Subsets: MEDLINE

Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Hagerstown, Md., Medical Dept., Harper & Row.

Radiculopathy*/surgery ; Spinal Fusion*/methods; Humans ; Reoperation/adverse effects ; Neck Pain/surgery ; Retrospective Studies ; Surgical Wound Infection/surgery ; Treatment Outcome ; Cervical Vertebrae/surgery ; Diskectomy/adverse effects

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.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

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Date Created: 20221018 Date Completed: 20230125 Latest Revision: 20230201

20240829

10.1097/BRS.0000000000004506

36255369