Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P120. Short-term outcomes following cervical laminoplasty and laminectomy and fusion with instrumentation.

BACKGROUND CONTEXT Conflicting reports exist in spine literature regarding short-term outcomes following cervical laminoplasty and posterior laminectomy and fusion. PURPOSE The objective of this study was to compare the 30-day outcomes for these two treatment groups for multilevel cervical pathology. STUDY DESIGN/SETTING Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2010-2015. PATIENT SAMPLE A total of 3,796 patients were included: 2,397 (63%) underwent cervical laminectomy and fusion and 1,399 (37%) underwent cervical laminoplasty. OUTCOME MEASURES Patient demographics, comorbidities, complications and outcomes compared between patients undergoing cervical laminoplasty or laminectomy and fusion. METHODS Patients who underwent cervical laminoplasty or posterior laminectomy and fusion were identified in the NSQIP database from 2010 to 2015 based on Current Procedural Terminology (CPT) code. Laminoplasty CPT codes included 63050 and 63051. Posterior cervical laminectomy CPT codes included 63015, 63045, and instrumentation was denoted by CPT code 22842. Patients with preoperative sepsis, wound infection, pneumonia, cancer, emergency cases and trauma, and surgery within the last 30days were excluded. Patient demographics and comorbidities were compared using bivariate logistic regression. Propensity-adjusted multivariate regressions were performed to assess differences in postoperative length of stay, adverse events, discharge disposition and readmission. RESULTS A total of 3,796 patients were included: 2,397 (63%) underwent cervical laminectomy and fusion and 1,399 (37%) underwent cervical laminoplasty. Both groups were similar in age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) score and Charlson Comorbidity Index (CCI) (P>.05 for all). Both groups had similar rates of malnutrition, chronic kidney disease (CKD), diabetes, chronic obstructive pulmonary disease, and history for steroid use. Age >70 and age <50 were not associated with one treatment group over the other (P>.05 for all). Compared with laminoplasty patients, laminectomy and fusion patients had increased lengths of stay (LOS) (4.5vs. 3.7days, P<.01) and increased rates of adverse events (41.7vs. 35.9%, P<.01), discharge to rehab (16.4vs. 8.6%, P<.01) and skilled nursing facilities (12.2vs. 9.7%, P=.02), and readmission (6.2vs. 4.5%, P=.05). Both groups experienced similar rates of death, pulmonary embolus, deep vein thrombosis, deep and superficial surgical site infection and reoperation P>.05 for all). Patients with CKD that underwent laminectomy and fusion had higher rates of transfusion (6.8vs. 20.4%, P=.05). Patients older than 70 that underwent laminectomy and fusion experienced high rates of urinary tract infection (6.4vs. 2.6%, P=.02). CONCLUSIONS Posterior cervical laminectomy and fusion patients were found to have increased LOS, readmissions, and complications despite having similar preoperative demographics and comorbidities. Patients and surgeons should consider these risks when considering surgical treatment for cervical pathology. [ABSTRACT FROM AUTHOR]