ArticleSpine surgery and related research2026
Delayed versus Same-Day Second-Stage Cervical Spine Surgery.
Article in Spine surgery and related research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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12 authors.
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Abstract
Background: Two-stage, anterior and posterior, cervical spine surgery is often utilized for complex spinal pathologies. The second stage may be performed on the same day or delayed to a separate day. A variety of considerations influence this decision, yet comprehensive and broad analyses examining predictors and outcomes of same-day versus delayed staging remain limited. Methods: A retrospective cohort study was conducted to investigate the effects of same-day versus delayed staging on complications and surgical outcomes. Adults undergoing two-stage cervical procedures were identified using the Quality Outcomes Database. The primary exposure was delaying the second-stage surgery to a separate day, termed the delayed second stage. Demographic, clinical, and preoperative data were analyzed. Outcomes included patient-reported outcome measures (PROMs) and reoperation rates at 3, 12, and 24 months, as well as the 30-day complication rate. Results: Among 394 patients (mean age 60.8±10.7, 52.0% male), 27.9% had delayed second-stage surgery, the majority had an anterior approach as the first stage (87.8%), and patients who had delayed second-stage surgery were less likely to have American Society of Anesthesiologists scores ≥3 (43.6% vs. 64.5%, p<0.001). Patients with delayed second-stage surgery had longer operative times (326±37.0 vs. 293±34.0 minutes, p=0.022) and longer hospital stays (4.4±0.79 vs. 3.1±0.54 days, p<0.001), with no significant differences in blood loss, reoperation rates, PROMs at 3, 12, and 24 months, or 30-day complication rates (all p>0.05). Conclusions: These results suggest that delaying the second stage may be more a question of resource utilization rather than concern for a negative impact on patient outcomes. Surgeons should acknowledge that either staging strategy, same-day or delayed, results in equivalent clinical outcomes with some differences in perioperative outcomes. The choice to delay second-stage surgery should be patient-centered and consider institutional factors.
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