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Outcome and Health-Related Quality of Life After Combined Anteroposterior Surgery Versus Anterior Surgery Alone in Subaxial Cervical Spine Fractures Analysis of a National Multicenter Data Set

Singh, Aman (author)
Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
Blixt, Simon (author)
Karolinska Inst, Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Reconstruct Orthoped, Stockholm, Sweden.
Edstrom, Erik (author)
Karolinska Institutet
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Elmi-Terander, Adrian (author)
Karolinska Institutet
Gerdhem, Paul (author)
Karolinska Institutet,Uppsala universitet,Ortopedi,Karolinska Inst, Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Uppsala Univ Hosp, Dept Orthoped & Hand Surg, Uppsala, Sweden.
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Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden Karolinska Inst, Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Reconstruct Orthoped, Stockholm, Sweden. (creator_code:org_t)
Ovid Technologies (Wolters Kluwer Health), 2023
2023
English.
In: Spine. - : Ovid Technologies (Wolters Kluwer Health). - 0362-2436 .- 1528-1159. ; 48:12, s. 853-858
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Study design.Observational study on prospectively collected data. Objectives.To compare patient-reported outcomes and complications after anteroposterior surgery or anterior surgery in subaxial cervical spine fractures. Summary of Background Data.There is no consensus regarding the optimal surgical approach for subaxial cervical spine fractures. Although anterior surgery is often sufficient to restore stability, anteroposterior surgery is sometimes preferred in severe instability. The effects of a more extensive procedure on patient-reported outcomes have not been investigated. We hypothesized that patient-reported outcomes and complication rates were similar between these surgical approaches. Materials and Methods.Individuals treated with either a combined anteroposterior or anterior surgery alone between 2006 and 2016 and with at least 1-year follow-up were identified in the Swedish Spine Registry. Cases were matched 1:2 for age (+/- 5 y). Outcomes were Neck Disability Index (NDI), EQ-5D-3L index, satisfaction, reoperations, and surgeon-reported and patient-reported complications within 90 days. Mann-Whitney U-tests and chi(2) tests were used in statistical comparisons. Results.The median [interquartile range] number of instrumented vertebrae was 3 [2-5.5] in the anteroposterior group and 2 [2-3] in the anterior group (P<0.001). The mean +/- SD follow-up time was 3.5 +/- 2.3 years in the anteroposterior and 3.8 +/- 2.0 years in the anterior group (P=0.39), respectively. At follow-up, Neck Disability Index was 20 [6-37] in the anteroposterior group and 18 [3.5-40] in the anterior group (P=0.69), and the median EQ-5D-3L index was 0.73 [0.12-0.80] in the anteroposterior group and 0.75 [0.62-0.89] in the anterior group (P=0.27). Satisfaction with the treatment was reported by 90% in the anteroposterior group and by 87% in the anterior group (P=0.98). None of the individuals in the anteroposterior and 6 of the individuals in the anterior group were reoperated (P=0.18). Conclusion.Patients operated on with anteroposterior or anterior surgery for subaxial cervical spine fractures are equally satisfied and report similar health-related quality of life measures.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Keyword

cervical spine fracture
surgery
outcome

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art (subject category)

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By the author/editor
Singh, Aman
Blixt, Simon
Edstrom, Erik
Elmi-Terander, A ...
Gerdhem, Paul
About the subject
MEDICAL AND HEALTH SCIENCES
MEDICAL AND HEAL ...
and Clinical Medicin ...
and Surgery
MEDICAL AND HEALTH SCIENCES
MEDICAL AND HEAL ...
and Clinical Medicin ...
and Orthopaedics
Articles in the publication
Spine
By the university
Uppsala University
Karolinska Institutet

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