Well-controlled asthma does not adversely affect outcomes following anterior cervical discectomy and fusion

Retrospective Cohort Study.

Recent studies have explored the negative impact that respiratory conditions have on outcomes after anterior discectomy and fusion (ACDF). However, the impact that asthmatic status has on postoperative outcomes remains unclear. The purpose of this study was to compare postoperative outcomes between patients with and without asthma who undergo ACDF.

Patients who underwent a primary, elective 1-4 level ACDF (2014-2020) with complete preoperative and 1-year postoperative Neck Disability Index (NDI) surveys were identified. Asthmatic status was determined and stratified into severity. Demographic, comorbidity, perioperative, and PROM data were collected. PROMs included the Visual Analog Scale (VAS) Neck and Arm, Mental Component Summary (MCS), Physical Component Summary (PCS), Modified Japanese Orthopaedic Association (mJOA) score, and NDI. Each PROM was assessed preoperatively and postoperatively at 12 months, with P < 0.05 considered significant.

1195 patients were included (81 (6.78%) had a history of asthma and 1114 (93.2%) did not). Of the asthmatic patients, 37 (45.8%) had well-controlled asthma and 44 (54.3%) had controlled asthma. Asthmatic patients were younger (52.7 vs. 56.1, P = 0.008) and had higher CCI scores (1.04 vs. 0.52, P < 0.001). There were no other differences in demographic variables, ED or readmission rates, 1-year reoperation rates, or PROMs between groups.

Patients with well-controlled asthma performed equally as well after anterior cervical fusion as those without asthma. Both groups had similar clinical and patient-reported outcomes, suggesting that having a preoperative diagnosis of well-controlled asthma does not increase risk of postoperative complications after ACDF.

III.