A new study published in The Journal of Bone and Joint Surgery examines cervical spine arthrodesis and the factors affecting long-term revision rates.
The researchers examined 87,042 patients who underwent primary subaxial cervical arthrodesis from 1997 and 2012 through New York State's all-payer healthcare database.
The researchers found:
1. Around 7 percent of the patients underwent revision surgery and the time to revision was 24.5 months on average.
2. The probability patients would have at least one revision procedure within the 16 year study period was 12.6 percent.
3. The patients who received surgery with an anterior-only approach reported having a significantly higher probability of revision. Those who had surgery with the anterior only approach had a 13.4 percent probability of revision while patients who underwent the posterior approach reported 7.4 percent probability. Patients who underwent the circumferential approaches had a 5.2 percent probability of revision surgery.
4. The factors that increased the risk of revision include:
• Patients age 18 to 34 years old
• White race
• Workers compensation or Medicare insurance
• Surgery for spinal stenosis, spondylolisthesis, deformity and neoplasm
5. Patients who had arthrodesis spanning just a few levels had a lower revision risk. The patients who underwent surgery for fractures also had a lower revision risk.