Does Facet Distraction Affect Patient Outcomes After ACDF?

Authors

• Brian A Karamian
• Hannah A Levy
• Jose A Canseco
• Dhruv K C Goyal
• Srikanth N Divi
• Joseph K Lee
• Mark F Kurd
• Jeffrey A Rihn
• Alan S Hilibrand
• Christopher K Kepler
• Alexander R Vaccaro
• Gregory D Schroeder

Publication/Presentation Date

4-1-2023

Abstract

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: The aim of this study is to determine if there is a correlation between the amount of facet distraction and postoperative patient-reported outcomes after ACDF.

METHODS: A retrospective cohort analysis of patients undergoing 1 to 3 level ACDF for degenerative pathologies at a single academic center was performed. Each patient received upright, lateral cervical spine x-rays at the immediate postoperative time point from which interfacet distance (facet distraction) was measured. Patient-reported outcome measures including NDI, PCS-12, MCS-12, VAS Neck, and VAS Arm pain scores were obtained preoperatively and at short-term (< 3 months) and long-term (>1 year) follow-up. Receiver operating curves were generated to evaluate the possibility of a critical interfacet distraction distance. Univariate and multivariate analysis were performed to compare outcomes between groups based on the degree of facet distraction.

RESULTS: A total of 229 patients met the inclusion criteria. Receiver operating curves failed to yield a critical interfacet distraction distance associated with worse post-operative outcomes. Patients were instead grouped based on facet distraction distance below and above the third quartile (0.8mm-2.0 mm, 2.0mm-3.7 mm), with 173 and 56 patients in each respective group. Univariate analysis did not detect any statistically significant differences in outcome measures, recovery ratio, or % MCID achievement at short- and long-term follow-up between groups. Multivariate analysis also failed to demonstrate any significant differences between the facet distraction groups.

CONCLUSION: Increased interfacet distance did not correlate with increased neck pain or disability after an ACDF.

Volume

13

Issue

3

First Page

689

Last Page

695

ISSN

2192-5682

Published In/Presented At

Karamian, B. A., Levy, H. A., Canseco, J. A., Goyal, D. K. C., Divi, S. N., Lee, J. K., Kurd, M. F., Rihn, J. A., Hilibrand, A. S., Kepler, C. K., Vaccaro, A. R., & Schroeder, G. D. (2023). Does Facet Distraction Affect Patient Outcomes After ACDF?. Global spine journal, 13(3), 689–695. https://doi.org/10.1177/21925682211004244

Disciplines

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

PubMedID

33759596

Department(s)

Administration and Leadership

Document Type

Article