Nationwide sample data analysis of additional surgery rate after anterior or posterior cervical spinal surgery

• Type of Material: Article
• Authors: Woon Tak Yuh, Hallym University; Minjung Kim, Seoul National University Hospital; Yunhee Choi, Seoul National University Hospital; Junghoon Han, Seoul National University Hospital; Junhoe Kim, Seoul National University Hospital; Taeshin Kim, Seoul National University Hospital; Chun Kee Chung, Seoul National University Hospital; Chang-Hyun Lee, Seoul National University Hospital; Sung Bae Park, Seoul National University Hospital; Kyoung-Tae Kim, Kyungpook Natl Univ Hosp; John Rhee, Emory University; Moon Soo Park, Hallym University; Chi H Kim, Seoul National University Hospital
• Language: English
• Date: 2023-04-18
• Publisher: NATURE PORTFOLIO
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-023-33588-z
• Title of Journal or Parent Work: SCIENTIFIC REPORTS
• Volume: 13
• Issue: 1
• Start Page: 6317
• End Page: 6317
• Grant/Funding Information: Funding was provided by Seoul National University Hospital (Grant No. 04-2021-0540) and Doosan Yonkang Foundation (Grant No. 800-20210527).
• Keywords: DISKECTOMY; LONGITUDINAL LIGAMENT; COHORT; FUSION; SPONDYLOTIC MYELOPATHY; REOPERATION RATE; LAMINOPLASTY; OSSIFICATION; CORPECTOMY; Multidisciplinary Sciences; Science & Technology; Science & Technology - Other Topics; DECOMPRESSION
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Surgical outcomes of degenerative cervical spinal disease are dependent on the selection of surgical techniques. Although a standardized decision cannot be made in an actual clinical setting, continued education is provided to standardize the medical practice among surgeons. Therefore, it is necessary to supervise and regularly update overall surgical outcomes. This study aimed to compare the rate of additional surgery between anterior and posterior surgeries for degenerative cervical spinal disease using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) nationwide patient database. The NHIS-NSC is a population-based cohort with about a million participants. This retrospective cohort study included 741 adult patients (> 18 years) who underwent their first cervical spinal surgery for degenerative cervical spinal disease. The median follow-up period was 7.3 years. An event was defined as the registration of any type of cervical spinal surgery during the follow-up period. Event-free survival analysis was used for outcome analysis, and the following factors were used as covariates for adjustment: location of disease, sex, age, type of insurance, disability, type of hospital, Charles comorbidity Index, and osteoporosis. Anterior cervical surgery was selected for 75.0% of the patients, and posterior cervical surgery for the remaining 25.0%. Cervical radiculopathy due to foraminal stenosis, hard disc, or soft disc was the primary diagnosis in 78.0% of the patients, and central spinal stenosis was the primary diagnosis in 22.0% of them. Additional surgery was performed for 5.0% of the patients after anterior cervical surgery and 6.5% of the patients after posterior cervical surgery (adjusted subhazard ratio, 0.83; 95% confidence interval, 0.40–1.74). The rates of additional surgery were not different between anterior and posterior cervical surgeries. The results would be helpful in evaluating current practice as a whole and adjusting the health insurance policy.