Surgical site infection after transoral versus posterior approach for atlantoaxial fusion: a matched-cohort study.
Journal of neurosurgery. Spine
OBJECTIVE In the past, spine surgeons have avoided the transoral approach to the atlantoaxial segment because of concerns for unacceptable patient morbidity. The objective of this study was to measure 30-day postoperative complications, especially surgical site infection (SSI), after transoral versus posterior approach to atlantoaxial fusion. METHODS The source population was provided by the American College of Surgeons National Surgical Quality Improvement Program database, which was queried for all patients who underwent atlantoaxial fusion for degenerative/spondylotic disease and/or trauma between 2005 and 2014. To eliminate bias from unequal sample sizes, patients who underwent the transoral approach were matched with patients who underwent the posterior approach (generally 1:5 ratio) based on age ± 5 years and modified frailty index score (a measure of preoperative comorbidity burden). Because of rare SSI incidence, adjusted odds ratios (OR
Medical Subject Headings
Adult; Aged; Atlanto-Axial Joint; Female; Humans; Joint Diseases; Male; Middle Aged; Minimally Invasive Surgical Procedures; Mouth; Retrospective Studies; Spinal Fusion; Surgical Wound Infection; Time Factors; Treatment Outcome