2-level disc replacement vs. ACDF: Which sees fewer readmissions?

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Patients having two-level cervical disc replacement tended to have fewer postoperative complications compared to those having two-level anterior cervical discectomy and fusion, according to a study published in the April 15 edition of Spine.

Researchers gathered data for two-level cervical disc replacement and ACDF patients using the PearlDiver M165Ortho database and matched the cohorts 1 to1 based on age, sex and Elixhauser comorbidity index scores. There were 4,224 patients in each study group.

Relative to patients having two-level ACDF, patients who had two-level cervical disc replacement saw significantly lower odds of 90-day dysphagia. The median 90-day cost of care was greater for the ACDF patients.

The study concluded that “patients undergoing two-level CDA were found to have significantly lower odds of 90-day readmissions and minor adverse events such as dysphagia, while rates of major adverse events including pulmonary embolism, deep-vein thrombosis or sepsis, were comparable between the groups. Further, patients undergoing CDA had lower cost of overall care, but no difference in five-year survival to cervical spine reoperation. Thus, it may be appropriate to further consider CDA when two-level surgery is pursued.”

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