Comparison of 30-day outcome following anterior cervical discectomy and fusion with or without instrumentation for cervical spondylosis: A review of 2352 elective cases

Background: Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure to address cervical myeloradiculopathy. However, 30-day outcomes after additional plating/instrumentation are not very clear. Methods: The authors reviewed The National Surgical Quality Improvement Program database to identify all elective ACDF cases with or without instrumentation for patients having cervical spondylosis with or without myelopathy from 2011 to 2013 using current procedural terminology and International Classification of Disease-9 codes. We identified 2352 cases and subdivided these into two cohorts based on instrumentation procedures (588 cases without instrumentation and 1764 cases with instrumentation). Baseline differences in two cohorts were adjusted by propensity score matching analysis, yielding well-matched 583 pairs. Results: Following propensity matching, the authors observed no significant difference in 30-day complication rates (prematch, 2.4% vs. 2.4%; and postmatch, 2.4% vs. 1.7%), readmission (prematch, 4.1% vs. 3.2%; and postmatch, 3.9% vs. 3.3%), and reoperation (prematch 0.9% vs. 1.8%; and postmatch 0.9% vs. 1.5%). Conclusion: Our results demonstrate similar 30-day outcomes in both cohorts and suggest that instrumentation can be safely implemented in the setting of ACDF.