Migraines as a Risk Factor for Many 90-Day Postoperative Complications Following Single-Level Anterior Cervical...

Area of Science:

• Neurosurgery
• Spine Surgery
• Patient Outcomes Research

Background:

• Anterior cervical diskectomy and fusion (ACDF) is a prevalent spinal procedure.
• Patient-specific factors, such as a history of migraines, may influence ACDF outcomes.
• The impact of migraines on postoperative adverse events following ACDF is not well-established.

Purpose of the Study:

• To investigate the association between a history of migraines and 90-day postoperative adverse outcomes after ACDF.
• To compare the rates of subsequent cervical spine surgeries within five years for patients with and without a history of migraines.

Main Methods:

• Utilized the 2015-2022 PearlDiver Mariner database for adult single-level ACDF patients.
• Excluded patients with concomitant spinal procedures, infections, trauma, or neoplasms.
• Employed 4:1 matching (migraine vs. no migraine) based on age, sex, and Elixhauser Comorbidity Index, followed by multivariate logistic regression and Kaplan-Meier survival analysis.

Main Results:

• Identified 16,434 (5.03%) ACDF patients with a history of migraines among 326,722.
• Matched cohorts included 14,774 migraine patients and 58,820 non-migraine patients.
• Migraine patients exhibited significantly higher odds of 90-day adverse events (any: OR 2.53, severe: OR 2.35, minor: OR 2.47) and ED visits (OR 3.42; P < 0.0001).

Conclusions:

• A history of migraines is linked to increased rates of most 90-day postoperative adverse outcomes following ACDF.
• Patients with migraines require enhanced risk counseling and postoperative planning for ACDF.
• No significant difference in 5-year revision cervical spine surgery rates was observed between groups.