Evidence mapPaperPMID 41567650Full record

ArticleNorth American Spine Society journal2026

Postoperative complications after anterior cervical discectomy and fusion in patients with versus without carotid artery stenosis.

Katie M Zehner, Julian Smith-Voudouris, Joshua G Sanchez, Sahir S Jabbouri, Yoji Ogura, Basar Atalay, Jonathan N Grauer, Arya G Varthi

Abstract read
In one paragraph

Article in North American Spine Society journal, 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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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Katie M ZehnerDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Julian Smith-VoudourisDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Joshua G SanchezDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Sahir S JabbouriDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Yoji OguraDepartment of Orthopedic Surgery, Atrium Health Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-Salem, NC 27157, United States.
Basar AtalayDepartment of Neurosurgery, University of Missouri-Columbia: 1 Hospital Dr, Columbia, MO 65212, United States.
Jonathan N GrauerDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Arya G VarthiDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.

Funding

NIA Short Term Research Training: Students in Health Professional SchoolsT35AG049685 · YALE UNIVERSITY · 2025 to 2025
$91k
NIA NIH HHS T35 AG049685
6 · The paper itself

Abstract

Background: Carotid artery stenosis (CS) may elevate risk of stroke related to anterior cervical discectomy and fusion (ACDF) due to manipulation of the carotid artery and alteration in flow dynamics. Prior studies assessing this potential association are limited by small sample size and assessment of in-hospital stroke only. Methods: A retrospective cohort study was conducted to compare 90-day adverse events following ACDF in patients with versus without CS. Adult patients (age >17 years) without a history of stroke who underwent isolated 1-3 level ACDF were identified in the 2010-2023 PearlDiver M170 database. Patients with CS were matched 1:4 to patients without CS based on age, sex, and Elixhauser comorbidity index (ECI). Adverse outcomes, emergency department (ED) visits, and readmissions in the 90 postoperative days were identified and compared between groups with univariable and multivariable analyses, the latter controlling for age, sex, and ECI. The timing of stroke following surgery was also plotted on a Kaplan-Meier survival curve and compared by log-rank test. A secondary analysis was conducted comparing CS patients with and without a history of revascularization procedure. Results: Among patients in the database undergoing ACDF, 17,772 with and 423,401 without CS were identified. Following matching, final cohorts consisted of 16,888 CS patients and 67,355 matched controls. CS was associated with greater odds of cardiac events (OR=1.74, p<.001) and stroke (OR=1.49, p<.001), but not other assessed adverse outcomes. The incidence of stroke continued to diverge for the 2 groups out to 90-days postoperatively. Of the CS patients, 2.8% had prior carotid revascularization. These patients had no difference in odds of stroke when compared to patients who had not undergone revascularization (p=.522). Conclusions: ACDF patients with CS were found to be at significantly elevated odds of cardiac events and stroke (adverse outcomes associated with atherosclerotic burden), but not other assessed adverse outcomes. Surveillance of related symptoms through the perioperative period is importantly considered.

Indexed as

ACDFCardiac riskCarotid stenosisCervicalDiscectomyOutcomesStroke

Identifiers

PMID41567650
PMCPMC12818360

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.