RT Journal Article
SR Electronic
T1 Clinical Outcomes of Single-Level Anterior Cervical Discectomy and Fusion
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 149
OP 153
DO 10.14444/5022
VO 12
IS 2
A1 STEVEN R. NIEDERMEIER
A1 SOHRAB S. VIRK
A1 SAFDAR N. KHAN
YR 2018
UL http://ijssurgery.com//content/12/2/149.abstract
AB Background: The purpose of the present study was to determine the differences in health outcomes between patients with cervical spondylosis who underwent single-level anterior cervical discectomy and fusion (ACDF) and patients with cervical spondylosis who did not undergo an ACDF fusion (non-ACDF). The hypothesis of the study was that patients undergoing single-level fusion have a lower risk of downstream cardiovascular disease and depression. Methods: The Medicare 5% sample was used to identify patients who received a diagnosis of spondylosis during 2005–2012. All spondylosis patients were separated into nonoperative and operative groups. Differences in new disease diagnoses, age, sex, and Charlson Comorbidity Index (CCI) scores were recorded.Results: The relative risk (RR) of heart failure was lower in the ACDF group after 3 years (RR = 0.6719; P < .05), 5 years (RR = 0.8477; P = 1.17), and 7 years (RR = 0.7709; P = 1.625). The RR of depression was higher in the ACDF group at 1 year (RR = 2.5008), 3 years (RR = 1.4473), 5 years (RR = 2.2625), and 7 years (RR = 2.2257; P < .05 for all). Mean CCI score of patients before undergoing ACDF was 10 (SD, 9.20), whereas the mean score after surgery was 8 (SD, 7.84; P < .05), and the score for non-ACDF patients remained unchanged at a CCI of 10 (SD, 9.00; P < .05).Conclusions: The results demonstrate the patients in the ACDF cohort have an increased RR of depression but a decreased risk of cardiovascular disease. Further research may be needed to delineate why the ACDF procedure potentially benefits a patient for heart disease but may stress a patient's social/economic supports during the recovery process, thus leading to higher depression rates for patients undergoing ACDF.