No Significant Differences in Postoperative Complications Between Outpatient and Inpatient Single-Level or Multiple-Level Cervical Disc Replacement for Cervical Radiculopathy

Authors

Anna Maria Ifarraguerri, Department of Orthopaedic Surgery, George Washington University Hospital, 2300 M St NW, Washington DC, 20037.
Alisa Malyavko, Department of Orthopaedic Surgery, George Washington University Hospital, 2300 M St NW, Washington DC, 20037.
William Travis Stoll, Department of Orthopaedic Surgery, George Washington University Hospital, 2300 M St NW, Washington DC, 20037.
Alex Gu, Department of Orthopaedic Surgery, George Washington University Hospital, 2300 M St NW, Washington DC, 20037.
Savyasachi Thakkar, Department of Orthopaedic Surgery, Adult Reconstruction Division, Johns Hopkins University, 10700 Charter Drive, Suite 205, Columbia MD, 21044.
Tushar Patel, Washington Orthopaedics and Sports Medicine, 2021 K Street NW, Suite 516, Washington DC, 20006.

Document Type

Journal Article

Publication Date

7-29-2022

Journal

Spine

DOI

10.1097/BRS.0000000000004441

Abstract

STUDY DESIGN: Retrospective Cohort Analysis. OBJECTIVE: To investigate the safety profile of outpatient versus inpatient single-level and multiple-level CDR by analyzing 1-year and 2-year surgical outcomes and 90-day medical complications using a large patient database. SUMMARY OF BACKGROUND DATA: Cervical disc replacement (CDR) is becoming a more desirable option for patients undergoing cervical spine procedures. Unlike anterior cervical discectomy and fusion (ACDF), CDR is motion-preserving and has been shown to reduce rates of adjacent segment disease. Current literature investigating outpatient versus inpatient CDR has shown a similar safety profile among the two cohorts. However, most of these studies have relatively small sample sizes with short-term follow-up. METHODS: A retrospective cohort study was done using the PearlDiver patient database between 2010 and 2019. Patients who underwent single-level and multiple-level CDR with a follow-up of at least 2 years were identified. Patients within each procedure cohort were subdivided into an outpatient and an inpatient group. Univariate and multivariable analyses were performed. RESULTS: In total, 2294 patients underwent single-level CDR of which 506 patients underwent outpatient CDR and 1788 underwent inpatient CDR. In total, 236 patients underwent multiple-level CDR of which 49 patients underwent outpatient CDR and 187 underwent inpatient CDR. In the single-level CDR cohort, patients undergoing outpatient CDR were found to have lesser odds of a decompressive laminectomy at 1-year following the initial procedure (OR: 0.471; CI: 0.205 to 0.945; P=0.05). No significant differences in 1-year and 2-year surgical complications, or 90-day postoperative complications, were found on multivariate analysis of outpatient versus inpatient multiple-level CDR. CONCLUSIONS: Our study found that performing single-level and multiple-level CDR on an outpatient basis has a similar safety profile to patients who underwent these procedures in an inpatient setting. LEVEL OF EVIDENCE: III.

APA Citation

Ifarraguerri, Anna Maria; Malyavko, Alisa; Stoll, William Travis; Gu, Alex; Thakkar, Savyasachi; and Patel, Tushar, "No Significant Differences in Postoperative Complications Between Outpatient and Inpatient Single-Level or Multiple-Level Cervical Disc Replacement for Cervical Radiculopathy" (2022). GW Authored Works. Paper 1253.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1253

Department

School of Medicine and Health Sciences Student Works