A recent study published in The Spine Journal examines and describes national trends in revision rates, complications and readmission for patients undergoing single and multilevel anterior cervical discectomy and fusion procedures.
Here are four things to know about the study:
1. The administrative database study describes national trends for ACDF procedures. According to the study, even with symptomatic and radiographic evidence of multilevel cervical disease, it is unclear whether single- or multilevel ACDF procedures produce superior outcomes in the long term.
2. Between 2006 and 2010, 92,867 patients were recorded for ACDF procedures in the Thomson Reuters MarketScan database. Researchers examined 28,777 patients, of which 12,744 underwent single-level and 16,033 underwent multilevel ACDFs.
3. The study found that:
• Perioperative complications were more common in multilevel procedures.
• Single-level ACDF patients had higher rates of postoperative cervical epidural steroid injections.
• Within 30 days after the procedure, the multilevel ACDF cohort was 1.6 times more likely to have undergone revision.
• At two years follow-up, revision rates were 9.13 percent in the single-level ACDF cohort and 10.7 percent for multilevel ACDFs.
• Also, at two years follow-up, it was found that patients from the multilevel cohort were more likely to have received a surgical revision, to have been readmitted into the hospital for any cause and to have suffered complications.
4. The study authors noted that increasing number of levels fused at the time of first surgery correlated with increased rate of reoperations and that multilevel ACDF patients requiring additional surgery more often underwent more extensive revision surgeries.
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