Proton Pump Inhibitor Use Affects Pseudarthrosis Rates and Influences Patient-Reported Outcomes.

Authors

• John J Mangan
• Srikanth N Divi
• James C McKenzie
• Justin D Stull
• William Conaway
• David S Casper
• Dhruv K C Goyal
• Kristen J Nicholson
• Matthew S Galetta
• Scott C Wagner
• I David Kaye
• Mark F Kurd
• Barrett I Woods
• Kristen E Radcliff
• Jeffery A Rihn
• D Greg Anderson
• Alan S Hilibrand
• Alexander R Vaccaro
• Gregory D Schroeder
• Christopher K Kepler

Publication/Presentation Date

2-1-2020

Abstract

STUDY DESIGN: Retrospective cohort review.

OBJECTIVES: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown. The purpose of this study was to determine if patients taking PPIs have higher rates of nonunion after ACDF.

METHODS: A retrospective cohort review was performed to compare patients who were taking PPIs preoperatively with those not taking PPIs prior to ACDF. Patients younger than 18 years of age, those with less than 1-year follow-up, and those undergoing surgery for trauma, tumor, infection, or revision were excluded. The rates of clinically diagnosed pseudarthrosis and radiographic pseudarthrosis were compared between PPI groups. Patient outcomes, pseudarthrosis rates, and revision rates were compared between PPI groups using either multiple linear or logistic regression analysis, controlling for demographic and operative variables.

RESULTS: Out of 264 patients, 58 patients were in the PPI group and 206 were in the non-PPI group. A total of 23 (8.71%) patients were clinically diagnosed with pseudarthrosis with a significant difference between PPI and non-PPI groups (

CONCLUSIONS: PPI use was found to be a significant predictor of clinically diagnosed pseudarthrosis following ACDF surgery. Furthermore, clinically diagnosed pseudarthrosis negatively influenced improvement in PCS-12 scores.

Volume

10

Issue

1

First Page

55

Last Page

62

ISSN

2192-5682

Published In/Presented At

Mangan, J. J., 3rd, Divi, S. N., McKenzie, J. C., Stull, J. D., Conaway, W., Casper, D. S., Goyal, D. K. C., Nicholson, K. J., Galetta, M. S., Wagner, S. C., Kaye, I. D., Kurd, M. F., Woods, B. I., Radcliff, K. E., Rihn, J. A., Anderson, D. G., Hilibrand, A. S., Vaccaro, A. R., Schroeder, G. D., & Kepler, C. K. (2020). Proton Pump Inhibitor Use Affects Pseudarthrosis Rates and Influences Patient-Reported Outcomes. Global spine journal, 10(1), 55–62. https://doi.org/10.1177/2192568219853222

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

32002350

Department(s)

Administration and Leadership

Document Type

Article