Written by Christopher Chalk, DC, MPH
Age and comorbidity burden are associated with higher rates of postsurgical mortality, longer lengths of in-hospital stay, higher hospital charges and a higher probability of being discharged to an outside care facility after atlantoaxial fusion, according to a large, new retrospective study.
Joseph Tanenbaum and colleagues from the Center for Spine Health at the Cleveland Clinic and School of Medicine at Case Western Reserve University reported their findings in a recent issue of The Spine Journal. The authors commented on the need for this type of large study. 
“Limitations caused by sample size and sampling bias render prior studies unable to accurately determine predictors of outcome following atlantoaxial fusion because they cannot control for confounders such as socioeconomic status, race, and patient clustering.”
The editors of The Spine Journal note that “These findings provide useful information that may be used for preoperative counseling for patients.” However, they also mention an important caveat. “Given the number of years included in this analysis, which span a time period of fairly rapid evolution in spinal instrumentation and surgical techniques, it is unclear that results are entirely relevant to patients with these issues who are receiving surgery today.”