A new study published in Spine examines multilevel posterior cervical decompression and fusion, posing the question of whether it's necessary to extend the multilevel procedures to the upper thoracic spine.
The researchers analyzed data from patients who underwent three or more level posterior cervical fusions and reported one year of clinical follow-up. The 219 patients included in the study were grouped by their caudal level of fusion: C7, T1 or T2-T4.
The researchers found:
1. There was an overall revision rate of 27.8 percent.
2. The revision rate for each group was:
● C7: 35.3 percent
● T1: 18.3 percent
● T2-T4: 40 percent
3. The patients who had constructs terminating at C7 were 2.29 times more likely to undergo revision procedures than those who had their primary surgeries extended to T1.
4. There wasn't any difference identified between the patients who had procedures that stopped at T1 and those that extended to T2-T4.
5. The study authors concluded, "Multilevel posterior cervical fusions should be extended to T1, as stopping a long construct at C7 increases the rate of revision."