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. 2023 Mar;13(2):432-442.
doi: 10.1177/2192568221998306. Epub 2021 Mar 12.

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Mohamed Kamal Mesregah  1   2 , Blake Formanek  1 , John C Liu  3 , Zorica Buser  1 , Jeffrey C Wang  1
Affiliations

Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Mohamed Kamal Mesregah et al. Global Spine J. 2023 Mar.

Erratum in

Abstract

Study design: Retrospective comparative study.

Objectives: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty.

Methods: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level.

Results: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001.

Conclusions: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion.

Keywords: ACDF; cervical spinal stenosis; degenerative cervical myelopathy; laminectomy and fusion; laminoplasty; propensity score matching.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart showing the number of patients in each group before and after propensity score matching.
Figure 2.
Figure 2.
Number of cases of the 3 procedures by year.
See this image and copyright information in PMC

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