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Reoperation Rates After Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Radiculopathy and Myelopathy: A National Population-Based Study.

Research paper by Moon Soo MS Park, Young-Su YS Ju, Seong-Hwan SH Moon, Tae-Hwan TH Kim, Jae Keun JK Oh, Melvin C MC Makhni, K Daniel KD Riew

Indexed on: 02 Apr '16Published on: 02 Apr '16Published in: Spine



Abstract

National population-based cohort study OBJECTIVE.: To compare the reoperation rates between cervical spondylotic radiculopathy and myelopathy in a national population of patients.There is an inherently low incidence of reoperation after surgery for cervical degenerative disease. Therefore, it is difficult to sufficiently power studies to detect differences between reoperation rates of different cervical diagnoses. National population-based databases provide large, longitudinally followed cohorts that may help overcome this challenge.We used the Korean Health Insurance Review & Assessment Service national database to select our study population. We included patients with the diagnosis of cervical spondylotic radiculopathy or myelopathy who underwent anterior cervical discectomy and fusion from January 2009 to June 2014. We separated patients into two groups based on diagnosis codes: cervical spondylotic radiculopathy or cervical spondylotic myelopathy. Age, sex, presence of diabetes, osteoporosis, associated comorbidities, number of operated cervical disc levels, and hospital types were considered potential confounding factors.The overall reoperation rate was 2.45%. The reoperation rate was significantly higher in patients with cervical spondylotic myelopathy than in patients with cervical radiculopathy (myelopathy: p = 0.0293, hazard ratio = 1.433, 95% confidence interval 1.037-1.981). Male gender, presence of diabetes or associated comorbidities, and hospital type were noted to be risk factors for reoperation.The reoperation rate after anterior cervical discectomy and fusion was higher for cervical spondylotic myelopathy than for cervical spondylotic radiculopathy in a national population of patients.3.