TY - JOUR
T1 - Risk factors associated with reoperation in posterior cervical fusions
T2 - A large-scale retrospective analysis
AU - Woodroffe, Royce W.
AU - Helland, Logan C.
AU - Grossbach, Andrew J.
AU - Nourski, Kirill V.
AU - Hitchon, Patrick W.
N1 - Publisher Copyright:
© 2020
PY - 2020/8
Y1 - 2020/8
N2 - Objectives: To identify risk factors for reoperation in patients who have undergone posterior cervical fusion (PCF). Patients and Methods: A retrospective cohort analysis was performed of patients undergoing PCF during a 12-year period at a single institution. Demographic and surgical characteristics were collected from electronic medical records. This study addressed reoperations, from all causes, of PCF. Different strategies, including the addition of anterior fusion, were also compared. Results: Of the 370 patients meeting inclusion criteria there were 44 patients (11.9 %) that required a revision and of those 5 required a second revision. The most common reasons for revision were adjacent segment disease and infection, 13 (3.5 %) and 11 patients (3.0 %), respectively. There was not a higher revision rate (for any cause) for patients who had a subaxial fusion and compared with those that included C2 or those that failed to cross the cervicothoracic junction. Of patients who required reoperation, there was a statistically significant higher fraction of smokers (p = 0.023). Conclusion: The risks and benefits of posterior cervical instrumentation and fusion should be thoroughly discussed with patients. This report implicates smoking as a risk factor for all-cause reoperation in patients who have had this PCF and provides surgeons with additional data regarding this complication. When possible, preoperative optimization should include smoking cessation therapy.
AB - Objectives: To identify risk factors for reoperation in patients who have undergone posterior cervical fusion (PCF). Patients and Methods: A retrospective cohort analysis was performed of patients undergoing PCF during a 12-year period at a single institution. Demographic and surgical characteristics were collected from electronic medical records. This study addressed reoperations, from all causes, of PCF. Different strategies, including the addition of anterior fusion, were also compared. Results: Of the 370 patients meeting inclusion criteria there were 44 patients (11.9 %) that required a revision and of those 5 required a second revision. The most common reasons for revision were adjacent segment disease and infection, 13 (3.5 %) and 11 patients (3.0 %), respectively. There was not a higher revision rate (for any cause) for patients who had a subaxial fusion and compared with those that included C2 or those that failed to cross the cervicothoracic junction. Of patients who required reoperation, there was a statistically significant higher fraction of smokers (p = 0.023). Conclusion: The risks and benefits of posterior cervical instrumentation and fusion should be thoroughly discussed with patients. This report implicates smoking as a risk factor for all-cause reoperation in patients who have had this PCF and provides surgeons with additional data regarding this complication. When possible, preoperative optimization should include smoking cessation therapy.
KW - Adjacent segment disease
KW - Cervical myelopathy
KW - Cervical spondylosis
KW - Posterior cervical fusion
KW - Revision
KW - Smoking
KW - Tobacco
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U2 - 10.1016/j.clineuro.2020.105828
DO - 10.1016/j.clineuro.2020.105828
M3 - Article
C2 - 32344282
AN - SCOPUS:85083663748
SN - 0303-8467
VL - 195
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
M1 - 105828
ER -