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• W3193141878 abstract "<h3>BACKGROUND CONTEXT</h3> ACDF surgery has long been a standard treatment option for spinal disc replacement and repair, but the effect of prior thyroidectomy on ACDF postoperative complications has not yet been investigated. <h3>PURPOSE</h3> The purpose of this study was to compare the risk of developing complications, primarily dysphagia and dysphonia, and revisions following ACDF surgery versus ACDF surgery with prior thyroidectomy. <h3>STUDY DESIGN/SETTING</h3> The study was a retrospective study from large, national database. <h3>PATIENT SAMPLE</h3> A total of 198,214 patients undergoing ACDF only and 711 patients undergoing ACDF with prior thyroidectomy were matched from private and public insurance claim records from 2010 to the first quarter of 2019. <h3>OUTCOME MEASURES</h3> Occurrence of revision surgery, readmission, complications, or prolonged opioid use following index surgery. <h3>METHODS</h3> The PearlDiver Research Program (www.pearldiverinc.com) was used to identify patients undergoing ACDF between the years of 2010 and 2019. These patients were divided into two cohorts: ACDF with prior thyroidectomy (CPT-60210, CPT-60212,CPT-60220, CPT-60225, CPT-60240, CPT-60252, CPT-60254, 60260, CPT-60270, CPT-60271, ICD-10-P-0GTG0ZZ, ICD-10-P-0GTG4ZZ, ICD-10-P-0GTH0ZZ, ICD-10-P-0GTK0ZZ, ICD-10-P-0GTK4ZZ, ICD-9-P-0639, ICD-9-P-064, ICD-9-P-0650, ICD-9-P-0651, ICD-9-P-065) and ACDF only (CPT-22548, CPT-22551, CPT-22554, CPT-22552, CPT-22585). Statistical matching was performed using demographic and relevant comorbidity variables. Postoperative outcomes were assessed for each cohort with multivariable logistic regression, controlling for age, sex, and Elixhauser Comorbidity Index. A p-value of .05 was set as the level of significance. <h3>RESULTS</h3> Of patients undergoing ACDF surgery with prior thyroidectomy, 13.1% experienced dysphagia at 1 year and 2.7% experienced dysphonia at 1 year. compared to patients who underwent only ACDF surgery. Compared to patients who undergoing ACDF surgery without prior thyroidectomy, those with prior thyroidectomy were at higher risk of both dysphagia (aOR=1.55, p=0.0001) and dysphonia (2.7% vs 0.9%, aOR=2.32, p=0.0007). However, there were no differences in 2-year ACDF revision (aOR=1.11, p=0.5471), 2-year subsequent posterior cervical fusion (PCF) (aOR=1.11, p=0.5690), 30d readmission (aOR=0.98, p=0.9360), total 30-day complications (aOR=1.07, p=0.5840), DVT (aOR=1.24, p=0.4120), and respiratory complications (aOR=0.62, p=0.0737). There were also no differences in postoperative opioid utilization rates at 1 month (aOR=0.92, p=0.4240), 3 months (aOR=0.80, p=0.0539), 6 months (aOR=0.86, p=0.1740), and 12 months (aOR=0.94, p=0.5910). <h3>CONCLUSIONS</h3> ACDF surgery with prior thyroidectomy is independently associated with increased risk of dysphagia and dysphonia at 1 year. However, there was not increased risk of revision surgery, medical complications, readmissions or opioid utilization. Further research is needed to investigate other potential complications and long-term postoperative outcomes arising from ACDF surgery with prior thyroidectomy. Spine surgeons should be cautious when considering ACDF surgery for patients with prior thyroidectomy and possibly consider PCF as a viable alternative where indicated. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs." @default.
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• W3193141878 date "2021-09-01" @default.
• W3193141878 modified "2023-10-16" @default.
• W3193141878 title "P129. ACDF with prior thyroidectomy leads to increased risk of dysphagia and dysphonia but not revisions" @default.
• W3193141878 doi "https://doi.org/10.1016/j.spinee.2021.05.337" @default.
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