Cervical Spinal Fusion: 16-Yr Developments in Epidemiology, Indications, and In-hospital Outcomes by Surgical Method.
World Neurosurg. 2018 Feb 10;:
Authors: Salzmann SN, Derman PB, Lampe LP, Kueper J, Pan TJ, Yang J, Shue J, Girardi FP, Lyman S, Hughes AP
BACKGROUND: The speed of cervical spinal fusion has been rising considerably. Nonetheless, there’s paucity of literature describing tendencies primarily based on surgical method utilizing full inhabitants databases. We investigated the approach-based tendencies in epidemiology, indications and in-hospital outcomes of cervical spinal fusion.
METHODS: New York’s Statewide Planning and Analysis Cooperative System database was queried to determine sufferers who underwent main subaxial cervical fusion from 1997-2012. Demographic and scientific data was obtained. Subgroup analyses have been carried out primarily based on surgical method – anterior (A), posterior (P), and circumferential (C).
RESULTS: 87,045 cervical fusions have been included. Over the examine interval, the population-adjusted annual fusion charge elevated from 23.7 to 50.6 per 100,000 inhabitants (p<zero.001). Anterior fusion was most typical (85.2%), adopted by posterior (12.three%), and circumferential (2.5%). Imply ages have been 49.eight±11.9, 59.9±15.2, and 55.1±14.5 years (p<zero.001), respectively. Though charges remained regular amongst youthful sufferers, they elevated for older sufferers. General, degenerative circumstances have been the predominant indications for surgical procedure and elevated in charge over time. The imply size of keep was: (A) three.1±10.5, (P) 9.1 ±14.1, and (C) 14.1±22.5 days (p<zero.001). Charges of in-hospital issues have been (A) three.zero%, (P) 10.5%, and (C) 18.9% (p<zero.001), and mortality charges have been (A) zero.three%, (P) 1.eight%, and (C) 2.5%, (p<zero.001).
CONCLUSIONS: The speed of subaxial spinal fusions elevated 114% from 1997 to 2012 in New York State. Charges remained steady in youthful sufferers however elevated within the older inhabitants. Preoperative indications and post-operative programs differed considerably among the many varied approaches, with anterior fusion sufferers having higher short-term outcomes.; Abbreviations: A: anterior, ACS NSQIP: American Faculty of Surgeons Nationwide Surgical High quality Enchancment Program, AIDS: acquired immune deficiency syndrome, ANOVA: evaluation of variance, C: circumferential, CDCI: Charlson Deyo comorbidity index, CHF: congestive coronary heart failure, CI: confidence intervals, CSF: cerebrospinal fluid, CSS: cervical backbone surgical procedure, CVDs: collagen vascular ailments, ICD: Worldwide Classification of Illness, LOS: size of keep, NIS: Nationwide Inpatient Pattern, P: posterior, PUD: peptic ulcer illness, RA: rheumatoid arthritis, SNF: expert nursing facility, SPARCS: Statewide Planning and Analysis Cooperative System.
PMID: 29438790 [PubMed – as supplied by publisher]