Adeesya Gausper, Andrew M Miller, Vivien Chan, Suhas K Etigunta, Andy M Liu, David Skaggs, Tiffany Perry, Corey Walker, Alexander Tuchman
{"title":"大型匹配队列中单节段前路颈椎椎间盘切除术和独立椎笼融合与前路钢板的再手术率。","authors":"Adeesya Gausper, Andrew M Miller, Vivien Chan, Suhas K Etigunta, Andy M Liu, David Skaggs, Tiffany Perry, Corey Walker, Alexander Tuchman","doi":"10.1097/BSD.0000000000001917","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To compare reoperation rates between single-level standalone anterior cervical discectomy and fusion (ACDF) and ACDF with anterior plating.</p><p><strong>Summary of background data: </strong>ACDF is a widely performed procedure for cervical degenerative disc disease and may utilize standalone cages or cages with anterior plating. Reoperation rate serves as a critical measure of long-term success and durability of each technique.</p><p><strong>Methods: </strong>The PearlDiver national insurance claims database was used to identify patients who underwent single-level ACDF with a standalone cage or ACDF with a plate. 1:1 matched cohorts were created based on age, sex, Elixhauser Comorbidity Index score, and year of surgery. The primary outcome was the reoperation rate at 2 years postoperatively. Secondary analyses included reoperation rate at 1-year and 5-years, reoperation stratified by surgical approach, and rate of epidural or facet injections at 2-years after index surgery. Statistical analyses included χ2 tests and Kaplan-Meier analysis to compare reoperation rates.</p><p><strong>Results: </strong>Nine thousand three hundred twenty-six patients were included in each cohort after matching. The 2-year reoperation rate was 3.26% for ACDF with plate and 3.31% for standalone ACDF (P=0.837). No significant difference was found in reoperation rates at 1-year, 2-year, and 5-year. Kaplan-Meier analysis additionally demonstrated no significant difference in reoperation-free survival over time. Patients undergoing standalone ACDF had higher rates of posterior approach reoperations within 2 years (1.22% vs. 0.84%, P=0.011). No significant differences were found in the rate of epidural or facet injections between groups.</p><p><strong>Conclusions: </strong>Standalone and plated single-level ACDF provide comparable long-term outcomes in terms of reoperation rates. This study is the largest matched cohort to date of patients who underwent single-level ACDF with and without anterior plating.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reoperation Rate Following Single-Level Anterior Cervical Discectomy and Fusion With Standalone Cage Versus Anterior Plating in a Large Matched Cohort.\",\"authors\":\"Adeesya Gausper, Andrew M Miller, Vivien Chan, Suhas K Etigunta, Andy M Liu, David Skaggs, Tiffany Perry, Corey Walker, Alexander Tuchman\",\"doi\":\"10.1097/BSD.0000000000001917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To compare reoperation rates between single-level standalone anterior cervical discectomy and fusion (ACDF) and ACDF with anterior plating.</p><p><strong>Summary of background data: </strong>ACDF is a widely performed procedure for cervical degenerative disc disease and may utilize standalone cages or cages with anterior plating. Reoperation rate serves as a critical measure of long-term success and durability of each technique.</p><p><strong>Methods: </strong>The PearlDiver national insurance claims database was used to identify patients who underwent single-level ACDF with a standalone cage or ACDF with a plate. 1:1 matched cohorts were created based on age, sex, Elixhauser Comorbidity Index score, and year of surgery. The primary outcome was the reoperation rate at 2 years postoperatively. Secondary analyses included reoperation rate at 1-year and 5-years, reoperation stratified by surgical approach, and rate of epidural or facet injections at 2-years after index surgery. Statistical analyses included χ2 tests and Kaplan-Meier analysis to compare reoperation rates.</p><p><strong>Results: </strong>Nine thousand three hundred twenty-six patients were included in each cohort after matching. The 2-year reoperation rate was 3.26% for ACDF with plate and 3.31% for standalone ACDF (P=0.837). No significant difference was found in reoperation rates at 1-year, 2-year, and 5-year. Kaplan-Meier analysis additionally demonstrated no significant difference in reoperation-free survival over time. Patients undergoing standalone ACDF had higher rates of posterior approach reoperations within 2 years (1.22% vs. 0.84%, P=0.011). No significant differences were found in the rate of epidural or facet injections between groups.</p><p><strong>Conclusions: </strong>Standalone and plated single-level ACDF provide comparable long-term outcomes in terms of reoperation rates. This study is the largest matched cohort to date of patients who underwent single-level ACDF with and without anterior plating.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":10457,\"journal\":{\"name\":\"Clinical Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Spine Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BSD.0000000000001917\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Spine Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BSD.0000000000001917","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Reoperation Rate Following Single-Level Anterior Cervical Discectomy and Fusion With Standalone Cage Versus Anterior Plating in a Large Matched Cohort.
Study design: Retrospective study.
Objective: To compare reoperation rates between single-level standalone anterior cervical discectomy and fusion (ACDF) and ACDF with anterior plating.
Summary of background data: ACDF is a widely performed procedure for cervical degenerative disc disease and may utilize standalone cages or cages with anterior plating. Reoperation rate serves as a critical measure of long-term success and durability of each technique.
Methods: The PearlDiver national insurance claims database was used to identify patients who underwent single-level ACDF with a standalone cage or ACDF with a plate. 1:1 matched cohorts were created based on age, sex, Elixhauser Comorbidity Index score, and year of surgery. The primary outcome was the reoperation rate at 2 years postoperatively. Secondary analyses included reoperation rate at 1-year and 5-years, reoperation stratified by surgical approach, and rate of epidural or facet injections at 2-years after index surgery. Statistical analyses included χ2 tests and Kaplan-Meier analysis to compare reoperation rates.
Results: Nine thousand three hundred twenty-six patients were included in each cohort after matching. The 2-year reoperation rate was 3.26% for ACDF with plate and 3.31% for standalone ACDF (P=0.837). No significant difference was found in reoperation rates at 1-year, 2-year, and 5-year. Kaplan-Meier analysis additionally demonstrated no significant difference in reoperation-free survival over time. Patients undergoing standalone ACDF had higher rates of posterior approach reoperations within 2 years (1.22% vs. 0.84%, P=0.011). No significant differences were found in the rate of epidural or facet injections between groups.
Conclusions: Standalone and plated single-level ACDF provide comparable long-term outcomes in terms of reoperation rates. This study is the largest matched cohort to date of patients who underwent single-level ACDF with and without anterior plating.
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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