Reoperation rates of anterior cervical discectomy and fusion versus posterior laminoplasty for multilevel cervical degenerative diseases: a population-based cohort study in taiwan

Abstract Background Context The reoperation (reop) rate is a crucial indicator of the efficacy of an operation; however, studies on the reop rates of anterior cervical discectomy and fusion (ACDF) or posterior laminoplasty (LMP) for treating multilevel cervical degenerative diseases (MCDDs) are scant. Purpose To compare the reop rates and safety of ACDF and LMP for MCDD treatment. Study Design A retrospective population-based cohort study. Patient Sample Patients who underwent ACDF and LMP treatment. Outcome Measures Reop rate, risk of pneumonia, sepsis, surgery-related complications, and death. Methods 6605 patients who underwent ACDF and 1578 patients who underwent LMP for MCDD treatment from 2001 to 2011 were selected from the Taiwan National Health Insurance Research Database. Cox proportional hazard models were performed to compare the clinical outcomes of the patients who underwent ACDF with those of the patients who underwent LMP. Results Long-term reop rates (per 100 person-month) was slightly higher in the patients who underwent ACDF (0.04 [95% confidence interval, CI: 0.03–0.05]) than those who underwent LMP (0.06 [95% CI: 0.04–0.08]), with adjusted hazard ratio (HR) of 1.43 (95% CI, 0.96-2.11, P =0.08) although short-term reop rates were significantly higher in the LMP group (0.41 [95% CI: 0.33–0.51]) than in the ACDF group (0.09 [95% CI: 0.07–0.11]), with adjusted HR of 4.81(95% CI, 3.46-6.69, P