Cannabis Use Disorder and Complications Following Anterior Cervical Discectomy and Fusion (ACDF)

Retrospective database analysis The aim of this study assesses the impact of baseline cannabis use disorder [CUD] on perioperative complication outcomes in patients undergoing primary 1-to-2-level anterior cervical discectomy and fusion (ACDF) surgery. The PearlDiver Database was queried from January 2010 to December 2021 for patients who underwent primary 1-to-2-level ACDF surgery for degenerative spine disease. Patients with CUD diagnosis six months prior to the index ACDF surgery, i.e., CUD, were propensity-matched with patients without CUD i.e., control in a ratio of 1:1, employing age, gender, and Charlson comorbidity index (CCI) as matching covariates. Univariate and multivariable analysis models with adjustment of confounding variables were utilized to evaluate the risk of CUD on perioperative complications between the propensity-matched cohorts. The 1:1 matched cohort included 838 patients in the CUD and 455 patients in the control group. Following multivariate analysis, CUD was demonstrated to be associated with an increased incidence of hospital readmission at 90 days [OR= 2.64, 95% CI: (1.19 to 6.78), (p=0.027)] and revision surgery at 1-year post-operatively [OR= 3.36, 95% CI: (1.17 to 14.18), (p=0.049)]. CUD was additionally associated with reduced risk of overall medical complications at both 6 months and one-year post-operatively [OR= 0.55, (p=0.021), and OR= 0.54, (p=0.015) respectively]. These findings indicate that isolated baseline CUD is associated with an increased risk of hospital readmission at 90 days postoperative and cervical spine reoperation at 1 year following primary 1-to-2-level ACDF surgery with a decrease in overall medical complications, cardiac arrhythmias, and acute renal failure.