Related Experiment Video

Updated: Jan 7, 2026

Anterior Cervical Discectomy and Fusion in the Ovine Model
06:11

Anterior Cervical Discectomy and Fusion in the Ovine Model

Published on: October 5, 2009

13.2K

Thrombocytosis Increases the Risk for Medical Complications and Extended Length of Hospital Stay Following Anterior

Haseeb E Goheer1, Liam Cleary1, Scott D Semelsberger1

  • 1Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA.

Clinical Spine Surgery
|December 31, 2025
PubMed

Insights

Preoperative thrombocytosis, not thrombocytopenia, independently increases the risk of medical complications and prolonged hospital stays following anterior cervical discectomy and fusion (ACDF) surgery. Platelet count testing is valuable for predicting adverse outcomes in ACDF patients.

Area of Science:

  • Neurosurgery and Orthopedic Spine Surgery
  • Hematology and Transfusion Medicine
  • Surgical Outcomes Research

Background:

  • Routine preoperative laboratory testing is standard before anterior cervical discectomy and fusion (ACDF).
  • Limited research exists on the impact of preoperative thrombocytopenia and thrombocytosis on ACDF outcomes.
  • Understanding these relationships can optimize patient selection and perioperative management.

Purpose of the Study:

  • To evaluate the association between preoperative platelet counts (thrombocytopenia and thrombocytosis) and perioperative outcomes in ACDF.
  • To identify specific platelet count thresholds that may predict adverse events.

Main Methods:

  • Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program database (2011-2021).
  • Identified 77,796 patients undergoing ACDF (CPT code 22551) and categorized them into five platelet count groups.
  • Multivariable logistic regression analyzed the relationship between preoperative platelet levels and postoperative complications.

Main Results:

  • The highest prevalence of medical complications was observed in the severe thrombocytopenia group.
  • Multivariate analysis revealed that preoperative thrombocytosis (platelet count >450k) was an independent predictor of increased medical complications (OR: 2.408) and extended hospital stay (OR: 3.001).
  • Neither mild nor severe thrombocytopenia showed independent association with increased medical complications or length of stay in multivariate analysis.

Conclusions:

  • Preoperative platelet count assessment is a valuable tool for predicting adverse outcomes in ACDF.
  • Thrombocytosis is independently associated with a higher risk of medical complications and prolonged hospitalization after ACDF.
  • These findings support incorporating platelet count into preoperative risk stratification for ACDF patients.
Abstract

Keywords:
Anterior cervical discectomy and fusioncomplicationsperioperative complicationsspinethrombocytosis

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