Comparison of complications associated with cervical spine surgery for traumatic injury versus degenerative disease in the United States
Introduction: Surgical complications contribute to patient morbidity and mortality as well as increase the cost of healthcare. With an increasing trend of negative incentivization for in-hospital complications, it is important to determine how patient diagnosis and procedure affects outcomes. The purpose of this study is to describe the incidence of and compare the in-hospital complications and mortality of cervical spine fusion surgery in traumatic spine injuries and degenerative disease. Methods: Data were obtained using the Nationwide Inpatient Sample (NIS) between 2007 and 2011. Patients with traumatic cervical spine injuries requiring fusion surgery (i.e. occipital-cervical (OCF), anterior cervical (ACF), posterior cervical (PCF)) were identified using the International Classification of Diseases, 9th edition (ICD-9). In-hospital complications associated with cervical fusions were also identified using ICD-9 codes. Univariate analysis was used to determine whether the complication rates of cervical fusions differed between traumatic injuries and degenerative disease. Results: From 2007-2011, 159,802 patients were admitted with traumatic cervical spine injuries (cervical spine fracture with or without spinal cord injury (SCI), cervical dislocation) and 804,150 were admitted with degenerative cervical disease. Of those with traumatic C-spine injuries 36,516 (22.8%) had a fusion. 605,879 (75.3%) patients with degenerative disease had fusion surgery. The overall complication rate for all types of cervical fusion procedures was found to be significantly higher in patients with traumatic cervical spine injuries. The complication rates based on type of traumatic cervical injuries requiring fusion surgery was also noted to be significantly higher than patients with degenerative disease. Conclusion: The complication rates of cervical fusion surgery were significantly higher in patients with traumatic injuries compared to those with degenerative disease. Thus, one may consider the admitting diagnosis in reviewing hospital quality and outcomes data for cervical fusion surgery instead of evaluation based on the procedure alone.
Lo, Victor, "Comparison of complications associated with cervical spine surgery for traumatic injury versus degenerative disease in the United States" (2015). Texas Medical Center Dissertations (via ProQuest). AAI1597540.