Synthetic Interbody Devices and Traditional Bone Graft Are Associated With a Similar Rate of Surgical Complications After 1-2 Level Anterior Cervical Discectomy and Fusions.

Autor:	Shukla G; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Matur AV; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Tao X; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Khalid S; Department of Neurosurgery, University of Illinois, Chicago, IL., Garner R; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Gibson J; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Cass D; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Wu A; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Street S; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Garcia-Vargas J; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Mehta J; Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH., Childress K; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Duah HO; Institute for Nursing Research and Scholarship, University of Cincinnati College of Nursing, Cincinnati, OH., Motley B; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Cheng J; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH., Adogwa O; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH.
Jazyk:	angličtina
Zdroj:	Spine [Spine (Phila Pa 1976)] 2024 May 01; Vol. 49 (9), pp. 615-620. Date of Electronic Publication: 2023 Sep 04.
DOI:	10.1097/BRS.0000000000004819
Abstrakt:	Study Design: Retrospective cohort. Objective: To compare the rates of all-cause surgical complications of synthetic interbody devices versus allograft or autograft in patients undergoing 1-2 levels anterior cervical discectomy and fusion (ACDF) procedures. Summary of Background Data: Cervical degenerative disorders affect up to 60% of older adults in the United States. Both traditional allograft or autograft and synthetic interbody devices (polyetheretherketone or titanium) are used for decompression and arthrodesis, with increasing utilization of the latter. However, the differences in their postsurgical complication profiles are not well-characterized. Patients and Methods: Patients who underwent 1-2 level ACDFs for cervical radiculopathy or myelopathy between 2010 and 2022 were identified using the PearlDiver Mariner all-claims insurance database. Patients undergoing surgery for nondegenerative pathologies, such as tumors, trauma, or infection, were excluded. 1:1 exact matching was performed based on factors that were significant predictors of all-cause surgical complications in a linear regression model. The primary outcome measure was the development of all-cause surgical complications after 1-2 level ACDFs. The secondary outcome was all-cause medical complications. Results: 1:1 exact matching resulted in two equal groups of 11,430 patients who received treatment with synthetic interbody devices or allograft/autograft. No statistically significant difference in all-cause surgical complications was found between the synthetic cohort and the allograft or autograft cohort after 1-2 level ACDFs (Relative Risk: 0.86, 95% confidence interval: 0.730-1.014, P = 0.079). No significant differences were observed regarding any specific surgical complications except for pseudoarthrosis (Relative Risk: 0.73, 95% confidence interval: 0.554-0.974, P = 0.037), which was higher in the allograft/autograft cohort. Conclusion: After 1:1 exact matching to control for confounding variables, the findings of this study suggest that all-cause surgical complications are similar in patients undergoing ACDFs with synthetic interbody devices or allograft/autographs. However, the rate of pseudarthrosis appears to be higher in patients with allograft/autographs. Future prospective studies are needed to corroborate these findings. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu