Comparison of revision surgeries for one- to two-level cervical TDR and ACDF from 2002 to 2011
Comparison of revision surgeries for one- to two-level cervical TDR and ACDF from 2002 to 2011
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DOI：
10.1016/j.spinee.2014.03.037
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发表时间：
2014-12-01
期刊：
影响因子：
4.5
通讯作者：
Singh, Kern
中科院分区：
文献类型：
--
作者：
Nandyala, Sreeharsha V.;Marquez-Lara, Alejandro;Singh, Kern
背景：颈椎全椎间盘置换术（TDR）和颈前路椎间盘切除术融合术（ACDF）对退行性颈椎病理提供了相当的结果。然而，这些程序的修订并没有得到很好的描述。目的：本研究的目的是检查翻修手术之间的发生率、流行病学、围手术期并发症和费用，并将这些结果与原发性病例的结果进行比较。研究设计：本研究为回顾性数据库分析。患者样本：从2002年至2011年全国住院患者样本（NIS）数据库中共纳入3,792例修订病例和183,430例原发性病例。结果测量：翻修病例的发生率、患者人口统计学、住院时间（LOS）、住院费用、死亡率和围手术期并发症。方法：对接受一至两级颈椎TDR或ACDF翻修的患者进行鉴定。采用SPSS v. 20进行统计分析，分类资料采用c2检验，连续资料采用独立样本t检验。与原发病例比较，采用95%置信区间计算翻修后围手术期并发症的相对风险。α水平小于0.05表示有统计学意义。结果：2002 - 2011年，NIS数据库共记录一至二级acdf改版3536例，tdr改版256例。修订后的宫颈TDR队列显示出更大的LOS (3.18 vs. 2.25, p
BACKGROUND CONTEXT: Cervical total disc replacement (TDR) and anterior cervical discectomy and fusion (ACDF) provide comparable outcomes for degenerative cervical pathology. However, revisions of these procedures are not well characterized.PURPOSE: The purpose of this study is to examine the rates, epidemiology, perioperative complications, and costs between the revision procedures and to compare these outcomes with those of primary cases.STUDY DESIGN: This study is a retrospective database analysis.PATIENT SAMPLE: A total of 3,792 revision and 183,430 primary cases from the Nationwide Inpatient Sample (NIS) database from 2002 to 2011 were included.OUTCOME MEASURES: Incidence of revision cases, patient demographics, length of stay (LOS), in-hospital costs, mortality, and perioperative complications.METHODS: Patients who underwent revision for either one-to two-level cervical TDR or ACDF were identified. SPSS v. 20 was used for statistical analysis with c 2 test for categorical data and independent sample t test for continuous data. The relative risk for perioperative complications with revisions was calculated in comparison with primary cases using a 95% confidence interval. An alpha level of less than 0.05 denoted statistical significance.RESULTS: There were 3,536 revision one-to two-level ACDFs and 256 revision cervical TDRs recorded in the NIS database from 2002 to 2011. The revision cervical TDR cohort demonstrated a significantly greater LOS (3.18 vs. 2.25, p