Wednesday, September 26, 2018 3:35 PM – 5:05 PM Preserving Spinal Motion: 85. The incidence of subsequent cervical spine surgery after cervical disc arthroplasty: a minimum two-year follow-up

Abstract

BACKGROUND CONTEXT In recent years, cervical disc arthroplasty (CDA) has emerged as an alternative surgical option to cervical arthrodesis. CDA is a motion-sparing device that mimics natural cervical motion, theoretically reducing adjacent level pathology. Surgical intervention rates following CDA have been reported via the FDA IDE studies as well as in several larger series. However, these studies and their findings may not be generalizable to the spine surgery community. PURPOSE Identify risk factors and incidence of subsequent cervical spine surgery in patients undergoing primary CDA. STUDY DESIGN/SETTING New York Statewide Planning and Research Cooperative Systems (SPARCS) database. METHODS We analyzed the SPARCS inpatient database from 2005 to 2015 to identify patients who underwent isolated CDA. International Classification of Diseases, Ninth Revision (ICD-9) codes were used to extract the index CDA procedure (84.61, 84.62) and to identify patient demographics and re-operation procedures. Patients were longitudinally followed until September 2015, corresponding to a minimum of two-year follow-up, to determine the incidence of subsequent cervical spine re-operation, which included another primary CDA, revision CDA, anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), and laminectomy without fusion. Univariate and multivariate analyses were used to identify demographic risk factors for subsequent re-operation. RESULTS A total of 835 patients underwent an inpatient CDA procedure between January 2005 and September 2013. After 2007, there was a decreasing number of inpatient CDA procedures performed in New York State (m=−33 cases/year, p CONCLUSIONS We identified a 7.5% incidence of subsequent cervical spine surgery after inpatient CDA, and a 4.4% re-operation rate at two years. Inpatient CDA procedures have been declining since 2008. Female sex was the only patient demographic factor to significantly influence the odds of cervical spine re-operation. Further investigation is needed to evaluate for the presence of these trends in outpatient databases. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.