Anterior Versus Posterior Approach for Multilevel Degenerative Cervical Disease: A Retrospective Propensity Score-Matched Study of the MarketScan Database

Spine
Tyler ColeJohn K Ratliff

Abstract

Retrospective 2:1 propensity score-matched analysis on a national longitudinal database between 2006 and 2010. To compare rates of adverse events, revisions procedure rates, and payment differences in anterior cervical fusion procedures compared with posterior laminectomy and fusion procedures with at least 3 levels of instrumentation. The comparative benefits of anterior versus posterior approach to multilevel degenerative cervical disease remain controversial. Recent systematic reviews have reached conflicting conclusions. We demonstrate the comparative economic and clinical outcomes of anterior and posterior approaches for multilevel cervical degenerative disk disease. We identified 13,662 patients in a national billing claims database who underwent anterior or posterior cervical fusion procedures with 3 or more levels of instrumentation. Cohorts were balanced using 2:1 propensity score matching and outcomes were compared using bivariate analysis. With the exception of dysphagia (6.4% in anterior and 1.4% in posterior), overall 30-day complication rates were lower in the anterior approach group. The rate of any complication excluding dysphagia with anterior approaches was 12.3%, significantly lower (P < 0.0001) than that of ...Continue Reading

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Citations

Jul 5, 2016·World Neurosurgery·Ran HarelNachshon Knoller
Sep 23, 2016·The Journal of Bone and Joint Surgery. American Volume·Peter B DermanStephen Lyman
May 18, 2018·Clinical Spine Surgery : a Spine Publication·Michael J ElsenbeckScott C Wagner
Feb 17, 2019·Journal of Neurosurgery. Spine·Hesham Mostafa ZakariaUNKNOWN MSSIC Investigators
Jan 9, 2020·Clinical Spine Surgery : a Spine Publication·Liam T KaneGregory D Schroeder
Sep 17, 2020·Der Unfallchirurg·P SchleicherF Kandziora
Apr 30, 2017·Global Spine Journal·Jeremy C PetersonK Daniel Riew
Nov 30, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·H KollerYohan Robinson
May 8, 2020·Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews·Majd MarracheAmit Jain
Nov 26, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yun-Qi JiangJian Dong
Mar 23, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Kevin Y WangAmit Jain

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