Risk Factors Of Dissatisfaction After Anterior Cervical Discectomy And Fusion

Objective:This paper is aimed to study the risk factors for patient dissatisfaction after anterior cervical discectomy and fusion(ACDF).Methods:This paper searched the in patients of Spinal Surgery,The Third Affiliated Hospital of Southern Medical University from Jan 2015 to Dec 2019 and collected 143 cases who were eligible for ACDF.It recorded the patients’ clinical data(age,gender,complication,medical history,follow-up visit duration,and BMI),operation data(segment and number),clinical efficacy(satisfaction,VAS,JOA,and NDI),imaging parameters(if the end plate is normal,CT value of fused segment centrum,C2-C7 Cobb angle[CL],and C2-C7 sagittal plane axial distance[SVA]),hospitalization cost,postoperative length of stay,and operation-related adverse event.It studied the risk factors for patient dissatisfaction after ACDF with t test/chi-square test and binary logistic regression.Results:The satisfaction rate of 143 patients is 76.92%.The t test/chi-square test and single factor analysis results show that the potential risk factors for patient dissatisfaction after ACDF include older age,disease duration more than one year,large intraoperative blood loss,three segments,and low preoperative VAS score.Further multiple-factor analysis results show that age(OR=1.057,p=0.018),disease duration more than one year(OR=4.329,p=0.007),intraoperative blood loss(OR=1.015,p=0.039),and low preoperative VAS score(OR=0.803,p=0.024)are the risk factors for patient dissatisfaction after ACDF.Conclusion:Older age,larger intraoperative blood loss,disease duration more than one year,and low preoperative VAS score are the risk factors for patient dissatisfaction after ACDF.