Effects of Prior Cervical Fusion on Patient Outcomes After Shoulder Arthroplasty

Abstract

Background The coexistence of cervical disease and shoulder pathology is not uncommon. The purpose of this study is to evaluate the early complication rates and outcomes after shoulder arthroplasty in patients with prior cervical arthrodesis. Methods A retrospective analysis was performed on a prospectively collected cohort at a single institution. Shoulder arthroplasty (TSA or RTSA) patients with prior cervical fusion (cervical arthrodesis-shoulder arthroplasty [CASA]) were identified and age-matched to controls without cervical fusion from 2012 to 2015. Early (<90-day) complications, visual analog scale (VAS) pain scores, and hospital length of stays were analyzed. Active shoulder range of motion (ROM) and American Shoulder and Elbow Surgeon (ASES) scores preoperatively, 6-week, 6-month, and 1-year postoperatively were compared. Results Seventeen CASA patients were matched to 34 controls. Patients were similar in gender, American Society of Anesthesiologist score, body mass index, opioid use, and arthroplasty procedure (TSA vs RTSA). CASA patients had similar postoperative VAS pain scores (4.6 vs 4.0), hospital length of stay (2.3 vs 2.5), and 90-day complications (3/17 vs 3/34) when compared to controls. Active shoulder ROM and ASES preoperatively and postoperatively at 6-week, 6-month, and 1-year were similar between the 2 groups. CASA patients had similar improvements in ASES scores at 1-year from preoperative scores when compared to controls (25.8 ± 24.3 vs 35.8 ± 21.4, P = .25). Conclusion Prior cervical fusion does not appear to be a risk factor for increased perioperative complications or poorer patient reported outcomes in patients undergoing shoulder arthroplasty.