Impact of teaching hospital status on postoperative outcomes following posterior cervical fusion/instrumentation.

BACKGROUND

Despite the high volume of posterior cervical fusions performed annually, the impact of academic versus non-academic hospital status on postoperative complications and readmissions requires clarification.

METHODS

A retrospective analysis was conducted to identify patients who underwent posterior cervical instrumentation from 2010 to 2022. Patients were grouped by academic or non-academic treatment setting. Propensity score matching controlled for age, gender, race, and comorbidities. Outcomes assessed included surgical and medical complications at 30 and 90 days, pseudoarthrosis or mechanical failure at 1-2 years, and readmission rates.

RESULTS

After matching, 4,344 patients per cohort demonstrated no significant differences in surgical complications or medical complications at 30 days and 90 days. Similarly, no significant difference was found in pseudoarthrosis or mechanical failure rates at 1-2 years postoperatively. However, non-academic centers had significantly higher readmission odds at 30 (Odds ratio [OR] = 2.325) and 90 days (OR = 2.232).

CONCLUSION

Patients undergoing posterior cervical instrumentation at non-academic centers experience similar surgical, medical, and mechanical complication rates compared to academic centers. However, significantly higher readmission rates for non-academic centers may indicate significant variations in postoperative care.