Patients with cervical degenerative disease have greater post-operative opioid use and reoperation following shoulder...

The interplay between cervical degenerative disease (CDD) and shoulder surgery remains poorly understood. In particular, the influence of CDD on the outcomes of instability procedures has not been investigated. This study aimed to evaluate the impact of CDD on post-operative complications, opioid use, and reoperation risk following shoulder instability surgery.

The TriNetX US Collaborative Network was queried for patients undergoing instability procedures without rotator cuff tears from 2015 to 2025. Patients were stratified based on a prior diagnosis of CDD to create 2 cohorts: CDD vs. no-CDD. Propensity score matching (1:1) was performed for demographics and comorbidities. Outcomes including arthroscopic and open reoperations, surgical complications (persistent pain, dislocation, and stiffness), arthroplasty, rotator cuff tear, and opioid use were compared at 2- and 5-year follow-up.

After matching, 778 patients were included in both the CDD and no-CDD cohorts. The risk of arthroscopic reoperation (odds ratio [OR], 1.682; 95% confidence interval [CI], 1.119-2.527), rotator cuff tear (OR, 2.033; 95% CI, 1.335-3.096), and persistent pain (OR, 1.266; 95% CI, 1.036-1.548) were significantly higher in the CDD cohort. These associations remained significant at 5 years. The CDD group had a greater number of opioid prescriptions at both time points (P < .001).

Patients with CDD were at an increased risk of post-operative pain, opioid utilization, rotator cuff tear, and arthroscopic reoperation following shoulder instability surgery. These findings suggest CDD may be a clinically relevant factor associated with suboptimal outcomes following shoulder instability surgery, warranting further investigation to guide targeted optimization strategies.