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Anterior cervical discectomy and fusion risks of obesity –

Results Out of medical charts reviewed, met the inclusion criteria.

Lucas Cox
Wednesday, November 27, 2019
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  • Sign In or Create an Account. This finding is in agreement with much of the literature regarding both cervical and lumbar fusion procedures.

  • Methods: One- and two-year medical resource utilization, missed work, and health state values QALYs were assessed. Separate univariable followed by multivariable logistic regression analysis were performed for the likelihood of perioperative inpatient outcomes among the patients with obesity.

  • There are several potential limitations in this study.

  • J Palliat Med 2 : — Our analysis of 1, patients showed that obesity is associated with several postoperative complications Table 4.

MeSH terms

Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option. Only one case underwent revision surgery. Results Out of medical charts reviewed, met the inclusion criteria.

We found no statistically significant difference between inpatient and outpatient ACDF in overall complications, incidence of stroke, thrombolytic events, dysphagia, and hematoma development. Vusion was the most common complication encountered in 3. Hoarseness was seen in 1. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF. Our study aims to determine the incidence of obesity in the ACDF population and the effects it may have on postoperative inpatient complications.

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Furthermore, several other studies have found no difference in early postoperative complications [ xiscectomy ]. Patient factors, comorbidities, and surgical characteristics that increase mortality and complication risk after spinal arthrodesis: a prognostic study based on 5, patients. Article Information. Sielatycki, MDJohn A. This allowed for the use of both age and CCI as independent variables in the multivariate regression analyses.

Most of the existing studies were retrospective, with a lack of level I or II studies on this topic. A total of 0. Conclusions While ACDF is considered a safe procedure, postoperative complications may have long-term implications. There was no significant difference in post-discharge health-care resource utilization, direct cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up. Obese patients had a lower mean cumulative gain in QALYs versus non-obese patients at 2-years 0.

This cohort was stratified into patients with diagnosis codes indicating obesity. Obesity, and specifically morbid obesity, should to be taken into consideration as physician and hospital reimbursements move toward a bundled model. Background: Although anterior cervical diskectomy and fusion ACDF is a safe and effective procedure, the complications associated with it cannot be underestimated. Higher quality, large prospective randomized control trials are needed to accurately demonstrate the safety profile of outpatient ACDF. Publication types Meta-Analysis Systematic Review.

Patients with missing data points were excluded from statistical analysis for that discectony variable. The incidence of reoperation was evaluated for a 2-year period after each index procedure. This is likely due to the increased thickness of the prevertebral tissue in obese patients that makes the approach and surgical manipulation more challenging. Permissions Legal Notices Feedback. Additionally, Table 2 displays the univariable logistic regression trends of obesity incidence. Luther 1Julian G. PRO scores were collected preoperatively, at 6 months postoperatively, and 2 years postoperatively.

Conclusion: Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties. Morbidly obese patients had lower QALYs gained discectomy and. The inadvertent dural tear was encountered in 1. Results Out of medical charts reviewed, met the inclusion criteria. Background: Although anterior cervical diskectomy and fusion ACDF is a safe and effective procedure, the complications associated with it cannot be underestimated. Obese ACDF patients had higher inpatient likelihood of dysphagia, neurological, respiratory, and hematologic complications as well as pulmonary emboli, and intraoperative durotomy. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF.

Williamson AHoggart B : Pain: a review of three commonly used pain rating scales. Obesity is an increasingly prevalent public health concern for both patients and medical practitioners. Twenty-five patients 8. Fifth, postdischarge narcotics use was not tracked; therefore, we could not quantify the effect of continued analgesic use on postoperative pain scores at the follow-up time points. Table 1.

This is reflective of the general resident population of Singapore, with For example, patient socioeconomic and demographic data were not collected and could not be adjusted for in the analysis. Anterior and posterior cervical fusion in patients with high body mass index are not associated with greater complications.

Seicean et al. An elevated body mass index has been linked to higher anr of spinal degenerative disease requiring surgical intervention. You do not currently have access to this article. However, the authors would like to stress that obese patients should still be counseled on the numerous other general health benefits of weight loss. Table 5.

PROMs The result of our multivariate analysis, after adjusting for gender, sex, smoking status, depression, and DM revealed that patients across all five BMI categories experienced similar levels of improvements in their postoperative PROS. POD 1. Google Scholar. There was no difference in absolute scores and change scores for any PRO at 12 months following surgery. Third, the retrospective nature of this study may be associated with selection bias. The NPRS is scored on a scale ranging from 0—10, with 0 indicating no pain and 10 indicating maximum pain.

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  • Study design: This study analyzed prospectively collected data. Mean hospital stay was

  • Overview of Literature The prevalence of cervical spondylosis and ACDF in expected to continue rising among the aging population of Asia. Diabetes mellitus.

  • Keywords: acdf; discectomy; fusion; saudi arabia; spine. Conclusions While ACDF is considered a safe procedure, postoperative complications may have long-term implications.

  • Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis.

Rlsks previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. A large database study with 2, patients conducted by Chung et al. No funds were received in support of this work. Smith GWRobinson RA : The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion.

Dysphagia was the most common complication encountered in 3. However, the safety profile of outpatient ACDF remains poorly defined. The anterior cervical discectomy and fusion risks of obesity of obesity amongst ACDF patients has risen dramatically during those years from 5. Conclusion: Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF. Abstract Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Abstract Background: Obese patients have greater comorbidities along with higher risk of complications and greater costs after spine surgery, which may result in increased cost and lower quality of life compared with their non-obese counterparts.

MeSH terms

Clinical Study. Finally, many studies have limited themselves anrerior comparing obese patients against normal-weight patients. Patients were independently assessed by the team preoperatively and then at 6 months and 2 years postoperatively. Multivariate analyses were adjusted for patient age, sex, smoking status, diabetes status, modified CCI, and number of operative levels.

Only one case underwent revision surgery. Methods A retrospective review of patients who underwent ACDF for degenerative disc disease fromin a single center in Riyadh, Saudi Arabia was performed. The incidence of obesity amongst ACDF patients has risen dramatically during those years from 5. Conclusion: Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF.

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Obese patients had a lower mean cumulative gain in QALYs versus non-obese patients at 2-years 0. We present one of cervidal largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF. Intraoperative complications were minimal. Patient demographic data, comorbidities, operative notes, immediate and delayed complications were all collected, with a minimum of 30 days follow-up. Our study aims to determine the incidence of obesity in the ACDF population and the effects it may have on postoperative inpatient complications.

Mean modified CCI. Thus, our purpose in this study was to determine if anterior cervical discectomy and fusion risks of obesity is an association between preoperative BMI and outcomes, narcotics utilization, and hospital costs after ACDF procedures. If fusion was not achieved at 6 months postoperatively and the patient was symptomatic at 1 year postoperatively, an additional CT scan was performed. They performed a similar study regarding posterior cervical surgery in patients and reported the thickness of subcutaneous fat was a significant risk factor for the development of a SSI The normality of continuous variables was assessed graphically and statistically. Moreover, the degree of benefit is comparable across BMI groups. Advanced Search Help.

Prevalence of osteoporosis and related lifestyle and metabolic factors of postmenopausal women and elderly men: a cross-sectional study in Gansu province, Northwestern of China. Haws Article by Krishna T. Prediabetes, type 2 diabetes mellitus and risk of Parkinson's disease: A population-based cohort study. While studies in the literature established an association between obesity and an increase in mortality, hospitalization costs, comorbidities, and postoperative complications in patients undergoing general and cardiac surgery, these studies are often small single-center cohorts [ 31012 ].

Methods: We systematically reviewed the literature for articles published before April 1,describing outpatient Dlscectomy and associated complications, including incidence of reoperation, stroke, thrombolytic events, dysphagia, hematoma, and mortality. There was no significant difference in post-discharge health-care resource utilization, direct cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up. We found no statistically significant difference between inpatient and outpatient ACDF in overall complications, incidence of stroke, thrombolytic events, dysphagia, and hematoma development. Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option. Conclusion: ACDF is a relatively safe procedure with very low morbidity and almost no mortality.

Conclusion: ACDF is a relatively safe procedure with very low morbidity and almost no mortality. Patient sample: Patients undergoing elective ACDF for degenerative cervical pathology at a single academic institution were included in the study. Study design: This study analyzed prospectively collected data. However, the safety profile of outpatient ACDF remains poorly defined. Methods: One- and two-year medical resource utilization, missed work, and health state values QALYs were assessed. Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis.

The database does not include adverse discecyomy after discharge, which prevents any evaluation of follow-up data, although the objective of this study is to report perioperative complications. The patient demography is further detailed in Table 1. Best Pract Res Clin Anaesthesiol 25 : 73 — 81 Herniated nucleus pulposus. View all jobs. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Mean hospital stay was Postoperative neck hematoma was seen in 0. This study showed minimal complications obedity the immediate postoperative period, but due to the limited sample size, a study with larger population is needed to further confirm the results. Conclusion: ACDF is a relatively safe procedure with very low morbidity and almost no mortality. An elevated body mass index has been linked to higher rates of spinal degenerative disease requiring surgical intervention. Obese ACDF patients had higher inpatient likelihood of dysphagia, neurological, respiratory, and hematologic complications as well as pulmonary emboli, and intraoperative durotomy.

Publication types

Background: Although anterior cervical diskectomy and ridks ACDF is a safe and effective procedure, the complications associated with it cannot be underestimated. A total of 0. This cohort was stratified into patients with diagnosis codes indicating obesity. The aim of this study was to highlight the potential complications associated with ACDF and the strategies to avoid them. Patient sample: Patients undergoing elective ACDF for degenerative cervical pathology at a single academic institution were included in the study.

Our analysis of 1, patients showed that obesity is associated with several postoperative complications Table 4. Monte Carlo computation of the fisher information matrix in nonstandard settings. Spine Phila Pa 40 : E — E Sami Walid MZaytseva NV : The impact of chronic obstructive pulmonary disease and obesity on length of stay and cost of spine surgery. John A. Volume Discussion Obesity is an increasingly prevalent public health concern for both patients and medical practitioners.

Spine Phila Pa —9. The mean worldwide BMI has been increasing by 0. Clin Orthop Relat Res : — Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. Results of this study indicated that there are no differences among BMI groups as regards outcomes of ACDF, including pain improvement, complication rate, arthrodesis rate, and reoperation rate. National, regional, and global trends in body-mass index since systematic analysis of health examination surveys and epidemiological studies with country-years and 9. With a rapidly ageing global population, the prevalence of spondylosis and the need for ACDF is expected to increase.

There was no significant difference in post-discharge health-care resource utilization, direct cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up. There was 0. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF.

  • Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. There was no difference in absolute scores and change scores for any PRO at 12 months following surgery.

  • Majority of population had no complications in a 30 days period

  • Clin Orthop Relat Res : — ,

  • Sielatycki, MD.

  • Obesity is associated with an increased rate of incidental durotomy in lumbar spine surgery.

However, studies present mixed results on the impact of obesity on ACDF surgical outcomes. Of note, the comorbidity burden was expressed as a modified form of the Charlson Comorbidity Index CCI with the age component removed. View all jobs. Medicine Baltimore e Patient and procedural characteristics for anterior cervical discectomy and fusion stratified by obesity. Article Navigation.

NIS sampling is clustered obeisty hospital identification HOSPID for all years and stratified by hospital region or hospital division for the years — and —, respectively. Matthew McGirt, MD. Spine Phila Pa 39 : — Univariable logistic regression trends of obesity incidence in anterior cervical discectomy and fusion patients. Spine ;E

The incidences and risk factors related to early cervicql after anterior cervical spine surgery: a prospective study. Length of procedure and stay Length of procedure and stay were analyzed using univariate analyzed, and no significant differences were found among the five groups. In the cervical region, Baker et al. Patients should be counseled to expect similar rates of postoperative complications and eventual clinical improvement regardless of their BMI. Statistical Methods Aggregate national estimates of yearly discharge frequencies were calculated utilizing weighted observations supplied by HCUP. Patients with a higher BMI demonstrated surgical outcomes, narcotics consumption, and hospital costs comparable to those of patients with a lower BMI.

Over our year study period, we observed a significant increase in obesity incidence cerrvical the ACDF population Fig. While our study also failed to find an association with increased in-hospital mortality rates, we did find a change in postoperative complication rates. Procedures alert. However, few studies have included BMI and those that had included BMI compared the obese group against the normal-weight group.

Two-level subanalysis. Results Total 19 3. Surgery for lumbar degenerative spondylolisthesis in Spine Patient Outcomes Research Trial: does incidental durotomy affect outcome? Osteoarthritis Cartilage 22 : — However, studies present mixed results on the impact of obesity on ACDF surgical outcomes.

Sign in via your Institution Sign in. Understanding the impact of obesity on short-term outcomes and in-hospital costs after instrumented spinal fusion. Mean operative time in mins. Original Article. In addition, existing studies have analyzed only the Western population, wherein BMI, comorbidity, and patient characteristics differ significantly from those in Asian populations.

Our results agree with these studies, that obesity is associated with early postoperative dysphagia. Subgroup analyses A multivariate subgroup analysis was performed on one-level and two-level ACDFs separately. Secondly, we did not further stratify patients into obesity subgroups, which may limit the applicability of the results to these specific cohorts, especially, morbidly obese patients, for which an association has been suggested [ 12 ].

Curr Orthop Pract —7. Int J Obes Lond ; Lancet ; Kudaravalli BSKelly H. Soft tissue edema, direct laceration of the esophagus, local ischemia due to increased intraesophageal pressure, pharyngeal plexus denervation by retractors, superior laryngeal nerve injury, or recurrent laryngeal nerve stretch injury during the lateralization of the larynx are possible etiologies for the development of dysphagia [ 26 ].

Differences in the prevalence of obesity, smoking and alcohol in the United States nationwide inpatient sample cervial the behavioral risk factor surveillance system. A similar result has been demonstrated by Armaghani et al. Two hundred seventy-seven patients were included in the analysis, of whom Ankur S. Abstract Study Design Retrospective cohort study.

In this study, the common complications encountered were postoperative dysphagia, dural injury, and hoarseness. Abstract Objective: Obesity has become a public health crisis and continues to be on the rise. Methods: One- and two-year medical resource utilization, missed work, and health state values QALYs were assessed.

Study design: This study analyzed prospectively collected data. Dysphagia was the most common complication encountered in 3. Higher quality, large prospective randomized control trials are needed to accurately demonstrate the safety profile of outpatient ACDF. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF. Results Out of medical charts reviewed, met the inclusion criteria.

  • J Neurosurg Spine — Obes Surg 24 : — ,

  • Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option. Conclusion: Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties.

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  • There was no significant difference in post-discharge health-care resource utilization, direct cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up.

Abstract Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Patients with advanced age and comorbidities such as obesity and significant myelopathy are likely not suitable for outpatient ACDF. All patients were operated by a single surgeon, who used the standard technique. Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Obese patients had a lower mean cumulative gain in QALYs versus non-obese patients at 2-years 0. The aim of this study was to highlight the potential complications associated with ACDF and the strategies to avoid them.

Download PDF. Cancel Save. Receive exclusive offers and updates from Oxford Academic. Table 3.

Obese patients had naterior lower mean cumulative gain in QALYs versus non-obese patients at 2-years 0. Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Purpose: The aim of the present study was to determine cost-utility following anterior cervical discectomy and fusion ACDF in obese patients. Mean hospital stay was

  • Patient demographics and analysis by Asian body mass index categories.

  • Conclusions While ACDF is considered a safe procedure, postoperative complications may have long-term implications. Methods: One- and two-year medical resource utilization, missed work, and health state values QALYs were assessed.

  • This finding is in agreement with much of the literature regarding both cervical and lumbar fusion procedures.

  • Reoperation rates. J Clin Med ;

  • Furthermore, obesity is also linked to lower socioeconomic status in developed economies that is itself linked to poorer outcomes in many surgical procedures [ 8 ].

Study design: This study analyzed prospectively collected data. Postoperative neck hematoma was seen in antrior. Methods: One- and two-year medical resource utilization, missed work, and health state values QALYs were assessed. We found no statistically significant difference between inpatient and outpatient ACDF in overall complications, incidence of stroke, thrombolytic events, dysphagia, and hematoma development.

Body mass index category was tested ecrvical an association with demographic, comorbidity, and operative characteristics using chi-square analysis or 1-way ANOVA for categorical and continuous variables, respectively. Seicean et al. J Clin Neurosci 18 : — Patients with a higher BMI demonstrated surgical outcomes, narcotics consumption, and hospital costs comparable to those of patients with a lower BMI. There was no difference in absolute scores and change scores for any PRO at 12 months following surgery. Advanced Search Help.

Patient and caregiver workday losses were multiplied by the fusjon gross-of-tax wage rate indirect cost. This study looks into the prevalence of possible complications and the mortality rate in the first 30 days postoperatively. This cohort was stratified into patients with diagnosis codes indicating obesity. Study design: This study analyzed prospectively collected data.

Anterioor, data on additional patient-reported outcome measures such as the Neck Disability Index or SF Physical and Mental Composite scores were unavailable for much of this patient population because of survey noncompliance. To that end, it has been observed that the NIS underreports obesity [ 39 ]. Looking for your next opportunity?

  • Factors predicting dysphagia after anterior cervical surgery: A multicenter retrospective study for 2 years of follow-up. Regression analyses were controlled for preoperative demographic and procedural characteristics.

  • Morbidly obese patients had lower QALYs gained 0. Methods: A total of patients was included in this retrospective study from to

  • We observed a lower likelihood of hardware failure in obese patients OR, 0.

  • There was 0. Purpose: The aim of the present study was to determine cost-utility following anterior cervical discectomy and fusion ACDF in obese patients.

Mean hospital stay was Higher quality, large prospective randomized control trials are needed to accurately demonstrate discectoym safety jeavons syndrome genetics and obesity of outpatient ACDF. Our data suggest that the number of obese patients undergoing ACDF is steadily increasing and had a higher inpatient likelihood of developing perioperative complications. Limited studies exist that evaluate the effects of obesity on perioperative complications in patients undergoing anterior cervical discectomy and fusion ACDF. Postoperative neck hematoma was seen in 0. Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis.

Length of procedure and stay Length of procedure and stay were analyzed risls univariate analyzed, and no significant differences were found among the five groups. Cite Cite John A. Conclusion Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties. Teraguchi et al. Prevalence of osteoporosis and related lifestyle and metabolic factors of postmenopausal women and elderly men: a cross-sectional study in Gansu province, Northwestern of China.

Hoarseness was seen in 1. Patient and caregiver workday losses were multiplied by nad self-reported gross-of-tax wage rate indirect cost. However, the existing literature suggests that outpatient ACDF can be safe, with low complication rates comparable to inpatient ACDF in well-selected patients. Higher quality, large prospective randomized control trials are needed to accurately demonstrate the safety profile of outpatient ACDF. Patients with advanced age and comorbidities such as obesity and significant myelopathy are likely not suitable for outpatient ACDF.

An elevated body mass index has been linked to higher rates of spinal degenerative disease requiring surgical intervention. Separate univariable followed by multivariable logistic regression analysis were performed for the likelihood of perioperative inpatient outcomes among the patients with obesity. Intraoperative complications were minimal. Majority of population had no complications in a 30 days period Dysphagia was the most common complication encountered in 3.

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Abstract Background: Although anterior cervical diskectomy and fusion ACDF is a safe and effective procedure, the complications associated with it cannot be underestimated. Patient demographic data, comorbidities, operative notes, immediate and delayed complications were all collected, with a minimum of 30 days follow-up. A random-effects analysis was performed comparing complications between the inpatient and outpatient groups. Results: We identified 21 articles that satisfied the selection criteria, of which 15 were comparative studies. A total of 0. Hoarseness was seen in 1.

Previous studies have demonstrated that obesity is associated with longer operative times and cerbical blood loss during spinal surgery. Moreover, the degree of benefit is comparable across BMI groups. Soft tissue edema, direct laceration of the esophagus, local ischemia due to increased intraesophageal pressure, pharyngeal plexus denervation by retractors, superior laryngeal nerve injury, or recurrent laryngeal nerve stretch injury during the lateralization of the larynx are possible etiologies for the development of dysphagia [ 26 ]. Keywords: body mass index ; ACDF ; narcotics ; outcomes ; complications ; direct cost ; cervical. An extension of the Wilcoxon rank-sum test for complex sample survey data.

Cost analyses are presented in Table 5. Conception and design: Singh, Narain, Hijji. No diabetes mellitus.

  • Conclusions Irrespective of the BM, patients exhibited similar outcomes following ACDF and showed equal levels of improvements and satisfaction.

  • Mean hospital stay was

  • Obese patients had worse baseline health status as indicated by higher Elixhauser readmission and mortality indexes.

  • J Neurosurg Sci ;

OR, cervicaal ratio. In the US, the estimated obesity prevalence is Our results revealed that while the obese II group had the highest reoperative risk at 8. Prediabetes, type 2 diabetes mellitus and risk of Parkinson's disease: A population-based cohort study. Compared to nonobese patients, obese ACDF patients were more likely to be female, frail, diabetic, and be from the Midwest or Western regions. Search Menu. This is based on the hypothesis that only obese subjects experienced inferior outcomes.

Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate indirect cost. Patient sample: Patients undergoing elective ACDF for degenerative cervical pathology at a single academic institution were included in the fusikn. Our data suggest that the number of obese patients undergoing ACDF is steadily increasing and had a higher inpatient likelihood of developing perioperative complications. However, the safety profile of outpatient ACDF remains poorly defined. Abstract Objective: Obesity has become a public health crisis and continues to be on the rise. However, the existing literature suggests that outpatient ACDF can be safe, with low complication rates comparable to inpatient ACDF in well-selected patients. Conclusion: Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF.

Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Conclusion: Obesity is a anterior cervical discectomy and fusion risks of obesity modifiable comorbidity that leads to increased perioperative complications in various surgical specialties. Abstract Background: Although anterior cervical diskectomy and fusion ACDF is a safe and effective procedure, the complications associated with it cannot be underestimated. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF. This cohort was stratified into patients with diagnosis codes indicating obesity. This study looks into the prevalence of possible complications and the mortality rate in the first 30 days postoperatively.

Results: We identified 21 articles cervicql satisfied the selection criteria, of which 15 were comparative studies. However, few studies reported post-operative complications. Two-year resource use was multiplied by unit costs based on Medicare national payment amounts direct cost. Mean hospital stay was This study looks into the prevalence of possible complications and the mortality rate in the first 30 days postoperatively.

Similarly, Kalanithi et al. Advanced Search. Table 1 displays the ACDF cohort characteristics stratified by obesity status. Finally, three patients were excluded because they had undergone previous cervical instrumentation, and the remaining patients were included in this study. Obesity Incidence Fig. The authors retrospectively reviewed a prospectively maintained surgical database of patients who had undergone primary 1- to 2-level ACDF for degenerative spinal pathology between and

J Clin Med ; Monte Carlo computation of the fisher information matrix in nonstandard settings. Table 1. Osteoarthritis Cartilage ;

Morbidly obese patients had lower cost-effectiveness; however, surgery does provide a significant improvement in outcomes. Majority of population had no complications in a 30 days period Conclusions While ACDF is considered a safe procedure, postoperative complications may have long-term implications. Most of the existing studies were retrospective, with a lack of level I or II studies on this topic. Conclusion: Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties.

Obese patients had a lower mean cumulative gain in QALYs versus non-obese patients risks 2-years 0. We present one of the largest retrospective analyses evaluating the effects obesiy obesity on inpatient complications following ACDF. There was no significant difference in post-discharge health-care resource utilization, direct cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up. Conclusion: Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties. Data pertaining to the postoperative complications and mortality were collected from the database. Results Out of medical charts reviewed, met the inclusion criteria.

The normality of continuous variables was assessed graphically and statistically. Multivariate analyses were adjusted for patient age, sex, smoking obssity, diabetes status, modified CCI, and number of operative levels. David Stonko, BS. Obesity and spine surgery: relation to perioperative complications. All these measurements were performed preoperatively and repeated postoperatively at the 6 months and 2 years after the surgery, when the patients were again assessed by the physiotherapists. The Neck Disability Index: a study of reliability and validity.

Additionally, there were no differences in the degree of improvement the groups after surgery. Boldface type indicates statistical significance. National, regional, and global trends in body-mass index since systematic analysis of health examination surveys and epidemiological studies with country-years and 9. They postulated that the increased costs may have stemmed from complications requiring more expensive treatment or an increased utilization of surgical supplies in obese patients.

  • Permissions Legal Notices Feedback.

  • Abstract Objective: Obesity has become a public health crisis and continues to be on the rise. Morbidly obese patients had lower cost-effectiveness; however, surgery does provide a significant improvement in outcomes.

  • BMI may not be the only risk factor to consider in obese patients.

  • Patients were excluded from this study if 2 years had not elapsed since their index procedure or if they had undergone surgery for traumatic etiologies.

  • Objective: Obesity has become a public health crisis and continues to be on the rise.

Regression analyses were controlled for preoperative demographic and procedural characteristics. Spine J —9. Another 80 patients were excluded because they underwent fusion of more than two cervical segments. Two-level subanalysis.

  • Large underreporting of COPD as cause of death-results from a population-based cohort study. However, this study by Sielatycki et al.

  • Two-year resource use was multiplied by unit costs based on Medicare national payment amounts direct cost.

  • Narain Articles by Fady Y. E-mail: clintondevin gmail.

  • We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF.

  • However, the existing literature suggests that outpatient ACDF can be safe, with low complication rates comparable to inpatient ACDF in well-selected patients.

Separate univariable followed by multivariable logistic regression analysis were performed for the likelihood of perioperative obesiyt outcomes among the patients with obesity. Conclusion: Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF. Only one case underwent revision surgery. Limited studies exist that evaluate the effects of obesity on perioperative complications in patients undergoing anterior cervical discectomy and fusion ACDF. Postoperative neck hematoma was seen in 0.

Surgical Technique The Smith-Robinson approach was used for all procedures, and implanted interbody cages were packed with autograft, allograft, or bone graft substitute. J Neurosurg Spine —7. Oxford University Press is a department of the University of Oxford. The mean BMI was Article Contents Abstract. Subdivision of the WHO obese category was not possible due to the small sample size.

Keywords: acdf; discectomy; fusion; saudi arabia; spine. Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option. However, the existing literature suggests that outpatient ACDF can be safe, with low complication rates comparable to inpatient ACDF in well-selected patients.

However, the safety profile of outpatient ACDF remains poorly defined. Abstract Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Background: Obese patients have greater comorbidities along with higher risk of complications and greater costs after spine surgery, which may result in increased cost and lower quality of life compared with their non-obese counterparts. Keywords: acdf; discectomy; fusion; saudi arabia; spine. Patients with advanced age and comorbidities such as obesity and significant myelopathy are likely not suitable for outpatient ACDF. Dysphagia was the most common complication encountered in 3. Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option.

Conclusions While ACDF is considered a safe procedure, postoperative complications may have long-term implications. However, anterior cervical discectomy and fusion risks of obesity studies reported post-operative complications. All patients were disks by a single surgeon, who used the standard technique. Conclusion: Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF. Abstract Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. Our study aims to determine the incidence of obesity in the ACDF population and the effects it may have on postoperative inpatient complications.

Methods: One- and two-year medical resource utilization, missed work, and health state values QALYs were assessed. Higher quality, large prospective randomized control trials are needed to accurately demonstrate the safety profile of outpatient ACDF. Conclusions While ACDF is considered a safe procedure, postoperative complications may have long-term implications. Morbidly obese patients had lower QALYs gained 0. Abstract Background: Although anterior cervical diskectomy and fusion ACDF is a safe and effective procedure, the complications associated with it cannot be underestimated. Background: Anterior cervical discectomy and fusion ACDF is being increasingly offered on an outpatient basis. The incidence of obesity amongst ACDF patients has risen dramatically during those years from 5.

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