1. Perioperative Outcomes and Reimbursement Patterns Associated With the Anterior versus Posterior Approach for Treatment of Type 2 Odontoid Fractures, a National Surgical Quality Improvement Program Analysis.
- Author
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El-Hajj VG, Ghaith AK, Al-Saidi NN, Nguyen R, Habashy KJ, and Elmi-Terander A
- Subjects
- Humans, Male, Female, Middle Aged, Adult, Treatment Outcome, Aged, Postoperative Complications epidemiology, Postoperative Complications economics, Operative Time, Length of Stay economics, Fracture Fixation, Internal economics, Fracture Fixation, Internal methods, Databases, Factual, Retrospective Studies, Odontoid Process injuries, Odontoid Process surgery, Spinal Fractures surgery, Spinal Fractures economics, Quality Improvement
- Abstract
Objective: To evaluate the short-term surgical outcomes and the reimbursement patterns, after treatment of type 2 odontoid fractures using the anterior or posterior approach., Methods: The National Surgical Quality Improvement Program database was queried for surgically treated patients with type 2 odontoid fractures by the anterior or posterior approach between 2016 and 2020. Propensity score matching with the optimal approach was used to balance the cohorts., Results: A total of 96 patients in the anterior and 352 patients in the posterior surgery group were included in the unmatched analysis. After propensity score matching 1:1, 96 anterior and 96 posterior cases were included in the matched analysis. Operative times were shorter in the anterior group (92.0 vs. 145.0 minutes, P < 0.001). The need for intraoperative or postoperative transfusions was higher in the posterior group (15% vs. 2.1%; P = 0.002). However, there were no significant differences in complications between groups (P > 0.05). Hospital stay was significantly longer in the posterior group (4.5 days vs. 3.0; P = 0.049). Nonroutine discharge was more frequent in the posterior group (55% vs. 40%, P = 0.030). However, the rate of 30-day readmission, reoperation, and mortality did not differ between groups (P > 0.05). Also, the work relative value units were significantly higher in the anterior group (22.7 vs. 20.6, P < 0.001), indicating higher reimbursement trends for this approach., Conclusions: In this matched analysis, the anterior approach for type 2 odontoid fractures was superior to the posterior approach. The anterior approach was associated with significantly shorter operation times, hospital stays, fewer transfusions, nonroutine discharges, and higher reimbursements., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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