ArticleJournal of spine surgery (Hong Kong)2026
Postoperative outcomes of multilevel versus single-level anterior cervical discectomy and fusion in patients with sarcopenia: a matched cohort study.
Article in Journal of spine surgery (Hong Kong), 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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Abstract
Background: Anterior cervical discectomy and fusion (ACDF) remains an effective treatment for cervical degenerative pathology. However, postoperative outcomes among patients with sarcopenia following multilevel versus single-level ACDF remain poorly understood. This study compared postoperative outcomes and complications between multilevel and single-level ACDF in patients with sarcopenia. Methods: A retrospective propensity-matched cohort study was conducted using the TriNetX database, including 2,873 patients with sarcopenia identified using International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) diagnostic codes who underwent single-level or multilevel ACDF between 2006 and 2026. One-to-one exact matching was done to control variables across multi-level ACDF and single-level ACDF cohorts. Short-term outcomes were assessed at 3 and 6 months, while long-term outcomes were evaluated at 1 and 2 years. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Independent t-tests and Chi-squared analyses were performed to compare continuous and categorical variables, respectively. Results: Sarcopenic multilevel ACDF patients demonstrated significantly higher rates of rehabilitation utilization, opioid use, and pseudoarthrosis during short-term follow-up, with persistent higher rates of pseudoarthrosis during long-term follow-up. At 3 months, multilevel ACDF patients demonstrated higher rehabilitation utilization (51.1% Conclusions: Sarcopenic patients undergoing multilevel ACDF demonstrated higher rates of postoperative opioid use, rehabilitation utilization, pseudoarthrosis, and new postoperative dysphagia compared with those undergoing single-level ACDF. These findings should be considered for careful preoperative risk assessment, patient counseling, and postoperative monitoring.
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