.png){kind=icon}
.png){kind=icon}
Return
The impact of rheumatoid arthritis and immunotherapy on outcomes following cervical fusion
.png){kind=icon}
PRE
AI
P
W
M
W
X
S
DOI：10.1016/j.jor.2026.03.019.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
Introduction/background Patients with RA are predisposed to spinal pathologies, particularly in the cervical spine. Studies demonstrate increased perioperative complications after orthopedic and lumbar procedures, yet large-scale data on cervical fusion outcomes remain limited. The aim of this study was to investigate the medical and surgical complications and healthcare utilization in patients with rheumatoid arthritis (RA) who underwent single-level anterior cervical discectomy and fusion (ACDF) or posterior cervical fusion (PCF). A secondary aim was to determine the impact of immunomodulatory therapy (IMT) on cervical fusion outcomes in the RA cohort. Methods In this retrospective cohort study, patients with RA over 18 years old who underwent ACDF or PCF between 2010 and 2022 were identified using the PearlDiver multi-payer database. Patients were matched in a 1:4 ratio based on age, gender, and Elixhauser Comorbidity Index (ECI). Both cohorts were evaluated for medical and surgical complications, healthcare utilization, and two-year mortality. A subgroup analysis compared patients with RA with and without a history of IMT. Results After single-level ACDF or PCF, patients with RA had significantly higher rates of medical and surgical complications, and healthcare utilization than non-RA counterparts. Patients with RA on IMT generally experienced a higher incidence of medical and surgical complications, as well as higher rates of healthcare utilization. Conclusion Patients with RA experienced higher rates of complications and increased healthcare utilization after cervical spine fusion surgery, with these risks further exacerbated by presence of preoperative IMT use. Further research is needed to determine mitigation strategies and understand perioperative risks associated with IMT in this population. Level of evidence Level III
Keywords:
Rheumatoid arthritis
Cervical fusion
Postoperative outcomes
Immunotherapy
Emergency department visits
Readmissions
Retrospective cohort study
Journal
J
IF:
1.5
Papers:
239
Citations:
3.2K
Organization
Cited Papers