Evaluation of the Congruency of National Surgical Quality Improvement Program Outcomes With a Propensity Matched Anterior Cervical Discectomy and Fusion, Posterior Lumbar Decompression and Fusion Cohort From an Institutional Registry.

Authors

• Omar H Tarawneh
• Jonathan Dalton
• Jarod Olson
• Rajkishen Narayanan
• Parker Brush
• Yunsoo Lee
• Olivia A Opara
• Delano Trenchfield
• Yashas C Reddy
• Mark Lambrechts
• Gokul Karthikeyan
• Grace Bowen
• Lan David Kaye
• Jory Parsons
• Patrick Fitzgerald
• John J Mangan
• Mark F Kurd
• Jose A Canseco
• Alan S Hilibrand
• Alexander R Vaccaro
• Gregory D Schroeder
• Christopher K Kepler

Publication/Presentation Date

7-1-2026

Abstract

STUDY DESIGN: Retrospective cohort.

OBJECTIVE: To compare institutional and National Surgical Quality Improvement Program (NSQIP) patients who underwent either anterior cervical discectomy and fusion (ACDF) or posterior lumbar decompression and fusion (PLDF) to determine the congruency of baseline characteristics and postoperative outcomes.

BACKGROUND: Large database studies have grown in prominence owing to their inexpensive nature, and ability to draw on large sample sizes. However, concerns regarding the accuracy and limitations of database studies have generated significant debate.

MATERIALS AND METHODS: A total of 954 patients who underwent ACDF/PLDF at our institution, and 9875 ACDF/PLDF patients from NSQIP were included. The NSQIP cohort was propensity matched to the institutional cohort for single-level ACDF and single-level PLDF procedures. Statistical analysis included either t-tests or Mann-Whitney U tests for continuous variables and χ 2 tests or Fisher exact tests for categorical variables.

RESULTS: The majority of postoperative complication rates did not differ significantly between the matched cohorts. Institution ACDF patients had shorter operative times and length of stay (LOS) compared with the NSQIP cohort. The institutional PLDF cohort had a higher 30-day readmission rate (3.13% vs 0.22%, P = 0.002) compared with the NSQIP PLDF cohort, while no differences were noted in 30-day readmission for ACDF. Institutional 90-day ACDF readmission rates were 2.36%, and institutional PLDF 90-day readmission rates were 7.14%, while NSQIP does not track 90-day readmission rates.

CONCLUSIONS: The current study offers a rigorous comparative analysis of ACDF and PLDF outcomes from NSQIP and a single institution. Although large databases are valuable in understanding trends and rare events, clinicians should be advised of the limitations of database research, such as missing data, selection bias, and coding variations, and their relevance to the unique population encountered within institutions.

LEVEL OF EVIDENCE: Level III.

Volume

39

Issue

6

First Page

302

Last Page

302

ISSN

2380-0194

Published In/Presented At

Tarawneh, O. H., Dalton, J., Olson, J., Narayanan, R., Brush, P., Lee, Y., Opara, O. A., Trenchfield, D., Reddy, Y. C., Lambrechts, M., Karthikeyan, G., Bowen, G., Kaye, L. D., Parsons, J., Fitzgerald, P., Mangan, J. J., Kurd, M. F., Canseco, J. A., Hilibrand, A. S., Vaccaro, A. R., … Kepler, C. K. (2026). Evaluation of the Congruency of National Surgical Quality Improvement Program Outcomes With a Propensity Matched Anterior Cervical Discectomy and Fusion, Posterior Lumbar Decompression and Fusion Cohort From an Institutional Registry. Clinical spine surgery, 39(6), E302–E308. https://doi.org/10.1097/BSD.0000000000001866

Disciplines

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

PubMedID

40521726

Department(s)

Administration and Leadership

Document Type

Article