• Anna M Ifarraguerri, Alisa Malyavko, William T Stoll, Alex Gu, Savyasachi C Thakkar, and Tushar Patel.
• Department of Orthopaedic Surgery, George Washington University Hospital, Washington, DC.
• Spine. 2022 Nov 15; 47 (22): 156715731567-1573.

Study DesignRetrospective cohort analysis.ObjectiveTo investigate the safety profile of outpatient versus inpatient single-level and multiple-level cervical disk replacement (CDR) by analyzing one- and two-year surgical outcomes and 90-day medical complications using a large patient database.Summary Of Background DataCDR is becoming a more desirable option for patients undergoing cervical spine procedures. Unlike anterior cervical diskectomy and fusion, 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.Materials And MethodsA 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 two years were identified. Patients within each procedure cohort were subdivided into an outpatient and an inpatient group. Univariate and multivariable analyses were performed.ResultsIn 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 one year following the initial procedure (odds ratio=0.471; 95% confidence interval: 0.205-0.945; P =0.05). No significant differences in one- and two-year surgical complications, or 90-day postoperative complications, were found on multivariate analysis of outpatient versus inpatient multiple-level CDR.ConclusionOur 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 Evidence3.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

22 keywords...

hide…