Influence of Surgeon Specialty on 30-day Outcomes Following Single-Level Cervical Disc Arthroplasty: A Propensity-Matched Analysis

Abstract

Study Design Retrospective, propensity-matched analysis Objectives Cervical disc arthroplasty (CDA) is being increasingly utilized for cervical disc generation. Surgeon specialty has been shown to influence the risk for postoperative complications in spine surgery, but this has not yet been explored for CDA. Thus, the purpose of this study is to determine whether there is any difference in 30-day complications between patients undergoing single-level CDA by neurosurgeons vs by orthopaedic surgeons. Methods A retrospective, 1:1 propensity score matched analysis was performed using the NSQIP database from 2015 to 2020. Patient demographics, operative characteristics, and postoperative complications were recorded. Independent multivariate logistic regression models were constructed using the propensity-matched dataset to assess surgical specialty influence on any complication, any site complication, any operative infection, and any medical complications. Results 3179 single-level CDAs (28.8% orthopaedic surgery patients, 71.2% neurosurgery patients) were identified that met the inclusion criteria. Well-matched cohorts of 916 patients each were generated. After controlling for all possible confounders, orthopedic surgery specialty was not associated with a higher odds for any complication (OR: .87, 95% CI: .35 – 2.20, P = .7696), any site complication (OR: .32, 95% CI: .08 – 1.32, P = .1359), any operative infection (OR: .31, 95% CI: .07 – 1.34), P = .1172), nor any medical complication (OR: 2.11, 95% CI: .62 – 7.20, P = .2311) vs neurosurgery. Conclusion This is the first propensity-matched analysis to show that spine surgeon specialty does not influence the risk for any complication, any site complication, any operative infection, nor any medical complication following single-level CDA within the first 30 days after surgery.