Comparison of Perioperative Complications in Anterior Decompression With Fusion and Posterior Decompression With Fusion for Cervical Ossification of the Posterior Longitudinal Ligament: Propensity Score Matching Analysis Using a Nation-Wide Inpatient Database.
Adult
Aged
Cerebrospinal Fluid Leak
/ etiology
Cervical Vertebrae
/ surgery
Decompression, Surgical
/ adverse effects
Deglutition Disorders
/ etiology
Female
Humans
Inpatients
Length of Stay
/ economics
Longitudinal Ligaments
/ surgery
Male
Middle Aged
Ossification of Posterior Longitudinal Ligament
/ surgery
Propensity Score
Reoperation
Retrospective Studies
Spinal Fusion
Treatment Outcome
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
15 Aug 2020
15 Aug 2020
Historique:
pubmed:
10
3
2020
medline:
24
11
2020
entrez:
10
3
2020
Statut:
ppublish
Résumé
A retrospective comparative study. To compare the perioperative complications and costs of anterior decompression with fusion (ADF) and posterior decompression with fusion (PDF) for patients with cervical ossification of the posterior longitudinal ligament (OPLL). Surgical treatment of cervical OPLL has a high risk of various complications. ADF and PDF are effective for the treatment of cervical OPLL; however, few studies have compared the two procedures in terms of the perioperative surgical complications. Patients undergoing ADF and PDF for cervical OPLL from 2010 to 2016 were identified in a nation-wide inpatient database. We investigated systemic and local complications, length of hospital stay, costs for hospitalization, reoperation, and mortality. Propensity score was calculated from patients' characteristics and preoperative comorbidities, and one to one matching was performed. Propensity score-matching produced 854 pairs of patients who underwent ADF and PDF. The rate of at least one systemic complication was significantly higher in the ADF group (P = 0.004). The incidence rates of postoperative respiratory failure (P = 0.034) and dysphagia (P = 0.008) were significantly higher in the ADF group. The rates of pneumonia (P = 0.06) and hoarseness (P = 0.08) also tended to be higher in the ADF group. However, no difference was found in the mortality rate (P = 0.22). In the local complications, spinal fluid leakage was significantly higher in the ADF group (P < 0.001). However, blood transfusion rate was significantly higher in the PDF group (P = 0.001). Hospital stay was significantly longer in the PDF group (P < 0.001) and the cost for hospitalization was greater in the PDF group (P < 0.001). The present study demonstrated that perioperative complications, such as respiratory failure, dysphagia, and spinal fluid leakage, were more common in the ADF group. However, hospital stay was longer in the PDF group, and the cost for hospitalization was greater in the PDF group. 3.
Sections du résumé
STUDY DESIGN
METHODS
A retrospective comparative study.
OBJECTIVE
OBJECTIVE
To compare the perioperative complications and costs of anterior decompression with fusion (ADF) and posterior decompression with fusion (PDF) for patients with cervical ossification of the posterior longitudinal ligament (OPLL).
SUMMARY OF BACKGROUND DATA
BACKGROUND
Surgical treatment of cervical OPLL has a high risk of various complications. ADF and PDF are effective for the treatment of cervical OPLL; however, few studies have compared the two procedures in terms of the perioperative surgical complications.
METHODS
METHODS
Patients undergoing ADF and PDF for cervical OPLL from 2010 to 2016 were identified in a nation-wide inpatient database. We investigated systemic and local complications, length of hospital stay, costs for hospitalization, reoperation, and mortality. Propensity score was calculated from patients' characteristics and preoperative comorbidities, and one to one matching was performed.
RESULTS
RESULTS
Propensity score-matching produced 854 pairs of patients who underwent ADF and PDF. The rate of at least one systemic complication was significantly higher in the ADF group (P = 0.004). The incidence rates of postoperative respiratory failure (P = 0.034) and dysphagia (P = 0.008) were significantly higher in the ADF group. The rates of pneumonia (P = 0.06) and hoarseness (P = 0.08) also tended to be higher in the ADF group. However, no difference was found in the mortality rate (P = 0.22). In the local complications, spinal fluid leakage was significantly higher in the ADF group (P < 0.001). However, blood transfusion rate was significantly higher in the PDF group (P = 0.001). Hospital stay was significantly longer in the PDF group (P < 0.001) and the cost for hospitalization was greater in the PDF group (P < 0.001).
CONCLUSION
CONCLUSIONS
The present study demonstrated that perioperative complications, such as respiratory failure, dysphagia, and spinal fluid leakage, were more common in the ADF group. However, hospital stay was longer in the PDF group, and the cost for hospitalization was greater in the PDF group.
LEVEL OF EVIDENCE
METHODS
3.
Identifiants
pubmed: 32150133
doi: 10.1097/BRS.0000000000003469
pii: 00007632-202008150-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E1006-E1012Références
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