Revision Rate and Opioid Use After Single-Level Versus Multi-Level Cervical Disc Arthroplasty: A Large Observational...

Area of Science:

• Neurosurgery and Orthopedic Surgery
• Spinal Fusion Alternatives
• Patient Outcomes Research

Background:

• Multilevel cervical disc arthroplasty (CDA) is utilized, but large-scale, longitudinal studies are lacking.
• Comparisons between single-level and multilevel CDA outcomes require further investigation.
• Understanding the long-term efficacy of multilevel CDA is crucial for surgical decision-making.

Purpose of the Study:

• To compare the clinical outcomes of multilevel cervical disc arthroplasty (CDA) with single-level CDA.
• To assess revision rates and pain management following single-level versus multilevel CDA.
• To evaluate the long-term effectiveness and safety of multilevel CDA.

Main Methods:

• Retrospective national database study of 15,705 patients undergoing single- or multilevel CDA (2017-2020).
• Primary outcomes: revision procedures and pain levels (opioid intake surrogate) at 90 days and 1 year.
• Statistical analysis included logistic regression and Kaplan-Meier survival analysis.

Main Results:

• Revision surgery incidence and odds were similar between single-level (5.27%) and multilevel (4.95%) CDA.
• Long-term opioid usage at 1 year showed no significant difference between the groups.
• Multilevel CDA patients were less likely to cease opioid use at 90 days post-procedure.

Conclusions:

• Multilevel cervical disc arthroplasty (CDA) demonstrates comparable revision rates to single-level CDA.
• Long-term opioid usage is similar between single-level and multilevel CDA.
• Multilevel CDA is a comparable alternative to single-level CDA for achieving successful clinical outcomes.