![]() 63 patients (91%) underwent 1-level and 6 patients (7%) underwent 2-level surgery. Average radiographic and clinical follow-up were 372 and 368 days, respectively. Mean patient age at surgery was 63.4☑.2 years, with a female predominance of 51%. Multivariate analysis demonstrated osteopenia or osteoporosis (OR: 4.97, 95% CI, p<0.01) and usage of PEEK implant (OR: 2.24, 95% CI, p=0.04) as independent predictors of pseudarthrosis.Ħ9 patients representing 75 operative levels met study inclusion criteria. Average length of follow-up was 27.6 and 23.8 months for patients with and without pseudarthrosis, respectively. Implant-type was also significantly associated with pseudarthrosis, with a 16.4% rate of pseudarthrosis for patients with polyetherethereketone (PEEK) implants versus 8.4% for patients with allograft implant (p=0.04). Presence of osteopenia or osteoporosis (16.3% vs 3.5%) was associated with pseudarthrosis (p<0.001). Age (54.1 vs 53.8 years), sex (34.9% vs 47.4% male), race, prior cervical spine surgery (37.2% vs 33.6%), tobacco abuse (16.3% vs 14.5%), chronic kidney disease (2.3% vs 2.8%), and diabetes (18.6% vs 14.5%) were not significantly different between patients with or without pseudarthrosis, respectively (p>0.05). 43 (13.2%) patients met criteria for pseudarthrosis, of which 15 underwent revision surgery (34.9%). Independent ambulatory status (0.88) and private insurance (0.85) were associated with higher likelihood of reaching MCID at 90 days.Ī total of 326 patients met inclusion criteria. Independent ambulatory status (0.83) and private insurance (0.83) were associated with higher likelihood of reaching MCID at 90 days.Īt 1 year after surgery, significant factors include: age (1.01), African American descent (1.20), less than high school education (1.34) chronic opiate use (1.25) current smoking (1.21) chronic obstructive pulmonary disease (COPD) (1.09) morbid obesity (1.30) history of DVT (1.12) depression (1.10) symptom duration more than 1 year (1.41) ASA class >2 (1.18) previous spine surgery (1.30) baseline PROMIS (1.06). At 90 days after surgery, significant factors include: less than high school education (1.20), African American descent (1.25) chronic opiate use (RR 1.23) current smoking (1.14) chronic obstructive pulmonary disease (COPD) (1.13) morbid obesity (1.15) scoliosis (1.06) history of DVT (RR 1.08) depression (1.09) anxiety (1.06) symptom duration more than 1 year (1.34) ASA class >2 (1.15) previous spine surgery (1.25) baseline PROMIS (1.06) surgery invasiveness (1.02). Significant adjusted relative risks are included in bracket next to individual item. We also identified 7,780 patients for 1-year follow up and 2,361 patients (30.3%) did not achieve MCID. We captured 10,922 patients for 90-day follow up and 4,453 patients (40.8%) did not reach MCID. Change in HRQOL measures were similar between all groups at 12-months after surgery. After adjusting for gender, ASA score, invasiveness of surgery, and presence of a postoperative complication, older adults with pre-operative depression had a 4.0 fold increased odds of high-decisional regret (p=0.04). Comparing patient cohorts reporting medium/high- versus low-decisional regret, there were no differences in baseline demographics, comorbidities, invasiveness of surgery, length of hospital stay, discharge disposition, or extent of functional improvement 12-months after surgery. A total of 21% regretted the choice that they made, and 21% responded that surgery caused them harm. ![]() Overall, 80% agreed that having surgery was the right decision for them, and 77% would make the same choice in future. ![]() ![]() There were no differences in demographics, comorbidities, invasiveness of surgery, or severity of baseline functional disability, between patients consenting to study participation and those that declined. Of the 155 patients, 91 consented to participate (response rate, 59%). A total of 155 patients (mean, 69.5 years) met the study inclusion criteria.
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