• Neurosurgery · Dec 2009

    Cervical spine reoperation rates and hospital resource utilization after initial surgery for degenerative cervical spine disease in 12,338 patients in Washington State.

    • Joseph T King, Khalid M Abbed, Grahame C Gould, Edward C Benzel, and Zoher Ghogawala.
    • Section of Neurosurgery, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA. joseph.kingjr@va.gov
    • Neurosurgery. 2009 Dec 1;65(6):1011-22; discussion 1022-3.

    ObjectivePatients undergoing surgery for degenerative cervical spine disease may require future surgery for disease progression. We investigated factors related to the rate of additional cervical spine surgery, the associated length of stay, and hospital charges.MethodsThe was a longitudinal retrospective cohort study using Washington state's 1998 to 2002 state inpatient databases and International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9) codes to analyze patients undergoing degenerative cervical spine surgery. Multivariate Poisson regression to identify patient and surgical factors associated with reoperation for degenerative cervical spine disease was used. Multivariate linear regressions to identify factors associated with length of stay and hospital charges adjusted for age, sex, year of surgery, primary diagnosis, payment type, discharge status, and comorbidities were also used.ResultsA total of 12,338 patients underwent initial cervical spine surgeries from 1998 to 2002; the mean follow-up duration was 2.3 years, and 688 patients (5.6%) underwent a reoperation (2.5% per year). Higher reoperation rates were independently associated with younger patients (P < 0.001) and a primary diagnosis of disc herniation with myelopathy (P = 0.011). Ventral surgery (P < 0.001) and fusion (P < 0.001) were both associated with lower rates of reoperation; however, a high correlation (Spearman's rho = 0.82; P < 0.001) made it impossible to determine which factor was dominant. Longer length of stay was independently associated with nonventral approaches (+1.0 day; P < 0.001) and fusion surgery (+0.8 day; P < 0.001). Greater hospital charges were independently associated with nonventral approaches (+$2900; P < 0.001) and fusion surgery (+$9600; P < 0.001).ConclusionPatients undergoing surgery for degenerative cervical spine disease undergo reoperations at the rate of 2.5% per year. An initial ventral approach and/or fusion seem to be associated with lower reoperation rates. An initial nonventral approach and fusion were more expensive.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

Want more great medical articles?

Keep up to date with a free trial of metajournal, personalized for your practice.
1,704,841 articles already indexed!

We guarantee your privacy. Your email address will not be shared.