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- Title
Readmissions, Complications, And Revisions For Occipitocervical And Occipitothoracic Fusion.
- Authors
Mehta, Vikram; Sciubba, Daniel M.; Abiola, Godwin; Ahmed, A. Karim; Goodwin, C. Rory; Pennington, Zachary; Abu-Bonsrah, Nancy; Sankey, Eric W.; Berry-Candelario, John; Gokaslan, Ziya L.; Bydon, Ali; Witham, Timothy; Wolinsky, Jean-Paul
- Abstract
Introduction: Occipitocervical (OC) and occipitocervicothoracic (OCT) fusions are commonly performed to correct biomechanical instability. However, there is limited data on the rates of revision and post-operative outcomes following OC or OCT procedures. Material and Methods: We performed a retrospective review of patients who underwent OC or OCT fusions at our institution from August 2005-October 2014. Patients' baseline characteristics, including age, gender, race, body mass index (BMI), co-morbidities, smoking history, presenting symptoms, and KPS score were recorded. Indication for surgery, surgical approach (i.e. anterior/posterior, or posterior alone), peri-operative and post-operative outcomes as well as last follow-up were also reviewed. Fusion was assessed via imaging and time to fusion was noted. Results: 131 patients were included in the study; 101 patients underwent OC surgeries and 30 patients underwent OCT surgeries. Indications for surgery included congenital malformations, trauma, tumor, inflammatory disease, infection or revisions. Differences in age, race and gender between the two groups were not statistically significant, however, patients in the OCT group had a significantly higher BMI than patients in the OC group (33.6 ± 4.158 and 26.23 ± 1.013, respectively, p = 0.0149). On average, patients undergoing OCT fusion had a significantly longer length of hospital stay, 16.60 ± 2.246 days, as compared to patients undergoing OC fusion, 11.16 ± 1.013 days (p = 0.0145). A significantly higher proportion of patients undergoing OC fusion were discharged with a KPS score greater than 70 compared to those undergoing OCT fusion (p = 0.0337). Between the OC and OCT groups, the frequency of patients with complications approached statistical significance (26.7% versus 43.3%, respectively, p = 0.083). However, when comparing the total number of complications between the two groups, the OCT patient group had a significantly higher proportion of complications than the patients in the OC group (0.8 ± 0.2112 and 0.404 ± 0.07 984, respectively, p = 0.0347). There were no significant associations between either type of surgery and rates of revision, hardware failure within 6 weeks, and readmission for any reason within 30 days. Conclusion: This study shows that there is no statistically significant difference between OC and OCT fusion patients with regards to readmission rate, or revision rate. However, on average, a patient undergoing OCT fusion is more likely to accrue more aggregate complications and experience a greater length of post-operative hospital stay, compared to a patient undergoing OC fusion.
- Publication
Global Spine Journal, 2018, Vol 8, p194S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771072