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Hybrid Anterior Cervical Discectomy and Fusion and Cervical Disc Arthroplasty: An Analysis of Short-Term Complications, Reoperations, and Readmissions.

Authors
  • Boddapati, Venkat1
  • Lee, Nathan J1
  • Mathew, Justin1
  • Vulapalli, Meghana M1
  • Lombardi, Joseph M1
  • Dyrszka, Marc D1
  • Sardar, Zeeshan M1
  • Lehman, Ronald A1
  • Riew, K Daniel1
  • 1 The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
Type
Published Article
Journal
Global Spine Journal
Publisher
SAGE Publications
Publication Date
Oct 01, 2021
Volume
11
Issue
8
Pages
1183–1189
Identifiers
DOI: 10.1177/2192568220941453
PMID: 32705903
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Retrospective cohort study. Although cervical disc arthroplasty (CDA) has become a well-established and effective treatment for symptomatic cervical degeneration, many patients with multilevel disease are not good candidates for CDA at all levels. For such patients, hybrid surgery (HS)-a combination of adjacent anterior cervical discectomy and fusion (ACDF) and CDA-may be more appropriate. Given the novelty of HS and the relative dearth of studies adequately assessing short-term perioperative complications, this current study sought to assess the short-term morbidity profile of HS, differences in operative duration, length of stay (LOS), and readmission and reoperation rates and reasons relative to a 2-level ACDF cohort. All patients who underwent HS and 2-level ACDF were identified between 2011 and 2018 using a large, prospectively collected registry. Baseline patient characteristics and postoperative complications were compared using bivariate and/or multivariate analysis. A total of 390 patients undergoing HS were identified. Two-level procedures were the most common (74.9%). Patients undergoing HS were more likely to be younger, male, and have fewer comorbidities. There were no differences between HS and 2-level ACDF in rates of any postoperative complication, transfusion, readmissions, and operative duration. However, HS had a decreased LOS (0.5 days), relative to a 2-level ACDF. HS patients had low rates of reoperation (1.28%) with 1 case for hematoma evacuation and another for revision CDA. This study represents one of the largest cohorts of patients undergoing HS reported to date. Patients undergoing HS are not at increased risk of perioperative complications relative to a 2-level ACDF and may benefit from shorter LOS.

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