Complications and Reoperation Following Surgery for Concurrent Carpal Tunnel and Cervical Spine Compression
Background: Patients with carpal tunnel syndrome (CTS) may also have cervical radiculopathy (CR) or vice versa, potentially requiring carpal tunnel release (CTR) and anterior cervical discectomy and fusion (ACDF). This study evaluates whether there is an increased risk of complications following CTR...
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| Veröffentlicht in: | Hand (New York, N.Y.) N.Y.), 2024-09, Vol.19 (6), p.917-923 |
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| creator | Li, Neill Y. Yang, Daniel S. Dwivedi, Shashank Gil, Joseph A. Daniels, Alan H. |
| description | Background:
Patients with carpal tunnel syndrome (CTS) may also have cervical radiculopathy (CR) or vice versa, potentially requiring carpal tunnel release (CTR) and anterior cervical discectomy and fusion (ACDF). This study evaluates whether there is an increased risk of complications following CTR or ACDF in patients with concurrent CTS and CR (CTS-CR) compared with those with only CTS or CR.
Methods:
A multipayer database was used to identify patients with CTS-CR. From this cohort, patients who underwent CTR and/or ACDF were identified. Patients with CTS-CR undergoing surgery were compared with those undergoing surgery with only CTS or CR. Multivariable logistic regression was used to compare matched populations to assess postoperative complications and risk of undergoing both procedures.
Results:
A total of 110 379 patients with CTS-CR were identified. Carpal tunnel release was performed in 21 152 patients (19.2%) with CTS-CR, from which 835 (0.76%) underwent ACDF. Anterior cervical discectomy and fusion was performed in 6960 patients (6.31%) with CTS-CR followed by CTR in 1098 patients (0.99%). Patients with CTS-CR were at greater risk of reoperation and complex regional pain syndrome following CTR. In ACDF, patients with CTS-CR were at greater risk of reoperation. Obesity and tobacco use were significant risk factors in patients with CTS-CR who underwent both CTR and ACDF rather than a single surgery.
Conclusions:
Examination of more than 100 000 patients with CTS-CR found a greater likelihood of reoperation and perioperative complications following surgery than those without concurrent diagnoses. Obesity and smoking increased the risk for patients undergoing both procedures. Patients presenting with CTS-CR are high risk and should be counseled on risk of complication and reoperation and optimized to reduce risk of undergoing both CTR and ACDF. |
| doi_str_mv | 10.1177/15589447231158807 |
| format | Article |
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Patients with carpal tunnel syndrome (CTS) may also have cervical radiculopathy (CR) or vice versa, potentially requiring carpal tunnel release (CTR) and anterior cervical discectomy and fusion (ACDF). This study evaluates whether there is an increased risk of complications following CTR or ACDF in patients with concurrent CTS and CR (CTS-CR) compared with those with only CTS or CR.
Methods:
A multipayer database was used to identify patients with CTS-CR. From this cohort, patients who underwent CTR and/or ACDF were identified. Patients with CTS-CR undergoing surgery were compared with those undergoing surgery with only CTS or CR. Multivariable logistic regression was used to compare matched populations to assess postoperative complications and risk of undergoing both procedures.
Results:
A total of 110 379 patients with CTS-CR were identified. Carpal tunnel release was performed in 21 152 patients (19.2%) with CTS-CR, from which 835 (0.76%) underwent ACDF. Anterior cervical discectomy and fusion was performed in 6960 patients (6.31%) with CTS-CR followed by CTR in 1098 patients (0.99%). Patients with CTS-CR were at greater risk of reoperation and complex regional pain syndrome following CTR. In ACDF, patients with CTS-CR were at greater risk of reoperation. Obesity and tobacco use were significant risk factors in patients with CTS-CR who underwent both CTR and ACDF rather than a single surgery.
Conclusions:
Examination of more than 100 000 patients with CTS-CR found a greater likelihood of reoperation and perioperative complications following surgery than those without concurrent diagnoses. Obesity and smoking increased the risk for patients undergoing both procedures. Patients presenting with CTS-CR are high risk and should be counseled on risk of complication and reoperation and optimized to reduce risk of undergoing both CTR and ACDF.</description><identifier>ISSN: 1558-9447</identifier><identifier>ISSN: 1558-9455</identifier><identifier>EISSN: 1558-9455</identifier><identifier>DOI: 10.1177/15589447231158807</identifier><identifier>PMID: 36946591</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Carpal Tunnel Syndrome - surgery ; Cervical Vertebrae - surgery ; Decompression, Surgical - adverse effects ; Decompression, Surgical - methods ; Diskectomy - adverse effects ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Radiculopathy - etiology ; Radiculopathy - surgery ; Reoperation - statistics & numerical data ; Retrospective Studies ; Risk Factors ; Spinal Fusion - adverse effects</subject><ispartof>Hand (New York, N.Y.), 2024-09, Vol.19 (6), p.917-923</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c292t-be247f1396b0baff90e299b36be040f4a09a3ba120d12f67d01fc713f1a8151b3</cites><orcidid>0000-0001-9149-4859</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/15589447231158807$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/15589447231158807$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36946591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Neill Y.</creatorcontrib><creatorcontrib>Yang, Daniel S.</creatorcontrib><creatorcontrib>Dwivedi, Shashank</creatorcontrib><creatorcontrib>Gil, Joseph A.</creatorcontrib><creatorcontrib>Daniels, Alan H.</creatorcontrib><title>Complications and Reoperation Following Surgery for Concurrent Carpal Tunnel and Cervical Spine Compression</title><title>Hand (New York, N.Y.)</title><addtitle>Hand (N Y)</addtitle><description>Background:
Patients with carpal tunnel syndrome (CTS) may also have cervical radiculopathy (CR) or vice versa, potentially requiring carpal tunnel release (CTR) and anterior cervical discectomy and fusion (ACDF). This study evaluates whether there is an increased risk of complications following CTR or ACDF in patients with concurrent CTS and CR (CTS-CR) compared with those with only CTS or CR.
Methods:
A multipayer database was used to identify patients with CTS-CR. From this cohort, patients who underwent CTR and/or ACDF were identified. Patients with CTS-CR undergoing surgery were compared with those undergoing surgery with only CTS or CR. Multivariable logistic regression was used to compare matched populations to assess postoperative complications and risk of undergoing both procedures.
Results:
A total of 110 379 patients with CTS-CR were identified. Carpal tunnel release was performed in 21 152 patients (19.2%) with CTS-CR, from which 835 (0.76%) underwent ACDF. Anterior cervical discectomy and fusion was performed in 6960 patients (6.31%) with CTS-CR followed by CTR in 1098 patients (0.99%). Patients with CTS-CR were at greater risk of reoperation and complex regional pain syndrome following CTR. In ACDF, patients with CTS-CR were at greater risk of reoperation. Obesity and tobacco use were significant risk factors in patients with CTS-CR who underwent both CTR and ACDF rather than a single surgery.
Conclusions:
Examination of more than 100 000 patients with CTS-CR found a greater likelihood of reoperation and perioperative complications following surgery than those without concurrent diagnoses. Obesity and smoking increased the risk for patients undergoing both procedures. Patients presenting with CTS-CR are high risk and should be counseled on risk of complication and reoperation and optimized to reduce risk of undergoing both CTR and ACDF.</description><subject>Adult</subject><subject>Aged</subject><subject>Carpal Tunnel Syndrome - surgery</subject><subject>Cervical Vertebrae - surgery</subject><subject>Decompression, Surgical - adverse effects</subject><subject>Decompression, Surgical - methods</subject><subject>Diskectomy - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Radiculopathy - etiology</subject><subject>Radiculopathy - surgery</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Spinal Fusion - adverse effects</subject><issn>1558-9447</issn><issn>1558-9455</issn><issn>1558-9455</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AQhhdRrFZ_gBfZo5fUnWSTzR4lWBUKgq3nsElnS-p2N-42Sv-96Ye9CJ5mGJ73gXkJuQE2AhDiHtI0l5yLOAFI85yJE3KxvUWSp-npcediQC5DWDLGszyX52SQZJJnqYQL8lG4VWuaWq0bZwNVdk7f0LXodwc6dsa478Yu6LTzC_Qbqp2nhbN15z3aNS2Ub5Whs85aNLt4gf6r9xk6bRuLdOv3GEJvuyJnWpmA14c5JO_jx1nxHE1en16Kh0lUxzJeRxXGXGhIZFaxSmktGcZSVklWIeNMc8WkSioFMZtDrDMxZ6BrAYkGlUMKVTIkd3tv691nh2FdrppQozHKoutCGYtcCmBJynsU9mjtXQgeddn6ZqX8pgRWbjsu_3TcZ24P-q5a4fyY-C21B0Z7IKgFlkvXedu_-4_xB3nQhXM</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Li, Neill Y.</creator><creator>Yang, Daniel S.</creator><creator>Dwivedi, Shashank</creator><creator>Gil, Joseph A.</creator><creator>Daniels, Alan H.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9149-4859</orcidid></search><sort><creationdate>20240901</creationdate><title>Complications and Reoperation Following Surgery for Concurrent Carpal Tunnel and Cervical Spine Compression</title><author>Li, Neill Y. ; Yang, Daniel S. ; Dwivedi, Shashank ; Gil, Joseph A. ; Daniels, Alan H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c292t-be247f1396b0baff90e299b36be040f4a09a3ba120d12f67d01fc713f1a8151b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Carpal Tunnel Syndrome - surgery</topic><topic>Cervical Vertebrae - surgery</topic><topic>Decompression, Surgical - adverse effects</topic><topic>Decompression, Surgical - methods</topic><topic>Diskectomy - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Radiculopathy - etiology</topic><topic>Radiculopathy - surgery</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Spinal Fusion - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Neill Y.</creatorcontrib><creatorcontrib>Yang, Daniel S.</creatorcontrib><creatorcontrib>Dwivedi, Shashank</creatorcontrib><creatorcontrib>Gil, Joseph A.</creatorcontrib><creatorcontrib>Daniels, Alan H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hand (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Neill Y.</au><au>Yang, Daniel S.</au><au>Dwivedi, Shashank</au><au>Gil, Joseph A.</au><au>Daniels, Alan H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complications and Reoperation Following Surgery for Concurrent Carpal Tunnel and Cervical Spine Compression</atitle><jtitle>Hand (New York, N.Y.)</jtitle><addtitle>Hand (N Y)</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>19</volume><issue>6</issue><spage>917</spage><epage>923</epage><pages>917-923</pages><issn>1558-9447</issn><issn>1558-9455</issn><eissn>1558-9455</eissn><abstract>Background:
Patients with carpal tunnel syndrome (CTS) may also have cervical radiculopathy (CR) or vice versa, potentially requiring carpal tunnel release (CTR) and anterior cervical discectomy and fusion (ACDF). This study evaluates whether there is an increased risk of complications following CTR or ACDF in patients with concurrent CTS and CR (CTS-CR) compared with those with only CTS or CR.
Methods:
A multipayer database was used to identify patients with CTS-CR. From this cohort, patients who underwent CTR and/or ACDF were identified. Patients with CTS-CR undergoing surgery were compared with those undergoing surgery with only CTS or CR. Multivariable logistic regression was used to compare matched populations to assess postoperative complications and risk of undergoing both procedures.
Results:
A total of 110 379 patients with CTS-CR were identified. Carpal tunnel release was performed in 21 152 patients (19.2%) with CTS-CR, from which 835 (0.76%) underwent ACDF. Anterior cervical discectomy and fusion was performed in 6960 patients (6.31%) with CTS-CR followed by CTR in 1098 patients (0.99%). Patients with CTS-CR were at greater risk of reoperation and complex regional pain syndrome following CTR. In ACDF, patients with CTS-CR were at greater risk of reoperation. Obesity and tobacco use were significant risk factors in patients with CTS-CR who underwent both CTR and ACDF rather than a single surgery.
Conclusions:
Examination of more than 100 000 patients with CTS-CR found a greater likelihood of reoperation and perioperative complications following surgery than those without concurrent diagnoses. Obesity and smoking increased the risk for patients undergoing both procedures. Patients presenting with CTS-CR are high risk and should be counseled on risk of complication and reoperation and optimized to reduce risk of undergoing both CTR and ACDF.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>36946591</pmid><doi>10.1177/15589447231158807</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9149-4859</orcidid></addata></record> |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Adult Aged Carpal Tunnel Syndrome - surgery Cervical Vertebrae - surgery Decompression, Surgical - adverse effects Decompression, Surgical - methods Diskectomy - adverse effects Female Humans Male Middle Aged Postoperative Complications - epidemiology Postoperative Complications - etiology Radiculopathy - etiology Radiculopathy - surgery Reoperation - statistics & numerical data Retrospective Studies Risk Factors Spinal Fusion - adverse effects |
| title | Complications and Reoperation Following Surgery for Concurrent Carpal Tunnel and Cervical Spine Compression |
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