Predicting Trends in Cervical Spinal Surgery in the United States from 2020 to 2040

Neifert, Sean N; Martini, Michael L; Yuk, Frank; McNeill, Ian T; Caridi, John M.; Steinberger, Jeremy; Oermann, Eric K.

doi:10.1016/j.wneu.2020.05.055

Cited by 92 publications

(68 citation statements)

References 33 publications

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“…The optimal surgical approach for multi-level degenerative cervical pathology, particularly for four-level disease, remains controversial. Options include anterior or posterior techniques, with four-level ACDF and four-level PCF available as treatment options [ 1 , 3 , 4 ]. The current study is the largest to date comparing short-term adverse events and long-term reoperation rates following four-level ACDF and PCF.…”

Section: Discussionmentioning

confidence: 99%

“…Cervical surgeries are commonly performed for degenerative conditions [1] . In the setting of multilevel spondylotic conditions, anterior cervical discectomy and fusion (ACDF) [2] versus posterior cervical fusion (PCF) may be considered [ 3 , 4 ]. While there are variables that may dictate approach, such as location of compression, cervical alignment, and surgeon preference, [ 5 , 6 ] there are situations where both are appropriate.…”

Section: Introductionmentioning

confidence: 99%

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Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates

Joo

Jayaram

McLaughlin

et al. 2022

North American Spine Society Journal (NASSJ)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates

Joo

Jayaram

McLaughlin

et al. 2022

North American Spine Society Journal (NASSJ)

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“…One of the most common procedures for treating patients with radiculopathy and/or myelopathy as a consequence of single-or multilevel CDDD is anterior cervical discectomy with fusion (ACDF) or without (ACD) [4]. A recent study by Neifert et al predicts a significant increase in ACDFprocedures in those aged 45-54 in the next 20 years which involves the working population [5][6][7]. Both techniques show good short-term clinical results [8].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of anterior surgical decompression surgery for cervical degenerative disk disease: a systematic review of economic evaluations

et al. 2022

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Purpose No clear consensus exists on which anterior surgical technique is most cost-effective for treating cervical degenerative disk disease (CDDD). One of the most common treatment options is anterior cervical discectomy with fusion (ACDF). Anterior cervical discectomy with arthroplasty (ACDA) was developed in an effort to reduce the incidence of clinical adjacent segment pathology and associated additional surgeries by preserving motion. This systematic review aims to evaluate the evidence regarding the cost-effectiveness of anterior surgical decompression techniques used to treat radiculopathy and/or myelopathy caused by CDDD. Methods The search was conducted in PubMed, EMBASE, Web of Science, CINAHL, EconLit, NHS-EED and the Cochrane Library. Studies were included if healthcare costs and utility or effectivity measurements were mentioned. Results A total of 23 studies were included out of the 1327 identified studies. In 9 of the 13 studies directly comparing ACDA and ACDF, ACDA was the most cost-effective technique, with an incremental cost effectiveness ratio ranging from $2.900/QALY to $98.475/QALY. There was great heterogeneity between the costs of due to different in- and exclusion criteria of costs and charges, cost perspective, baseline characteristics, and calculation methods. The methodological quality of the included studies was moderate. Conclusion The majority of studies report ACDA to be a more cost-effective technique in comparison with ACDF. The lack of uniform literature impedes any solid conclusions to be drawn. There is a need for high-quality cost-effectiveness research and uniformity in the conduct, design and reporting of economic evaluations concerning the treatment of CDDD. Trial registration PROSPERO Registration: CRD42020207553 (04.10.2020).

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“…In our worldwide aging society, the number of patients with degenerative cervical disorders has been increasing 1 , and because of this, it has been reported that the number of cervical spine surgeries has increased in recent decades 2 . In addition, these numbers are predicted to increase in the coming decades due to the progression of aging in our society 3 . Improvement of perioperative management and surgical techniques can help us to implement relatively highly invasive cervical spine surgeries, such as for cervical deformity, even in patients with advanced age and/or multiple comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Surgical Apgar Score and Controlling Nutritional Status Score are significant predictors of major complications after cervical spine surgery

Miura

Koda

Funayama

et al. 2022

Sci Rep

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Nutritional screening scores, including Controlling Nutritional Status (CONUT) Score and Surgical Apgar Score (SAS), which reflect intraoperative hemodynamics, have been reported to be useful for predicting major postoperative complications in various kinds of surgery. We assessed independent risk factors for major complications after cervical spine surgery using those scoring measurements. We retrospectively reviewed medical records of patients who underwent cervical spine surgery at our institution from 2014 to 2019. Baseline clinical information, including the CONUT Score, and surgical factors, including the SAS, were assessed as risk factors for major postoperative complications. We analyzed 261 patients. Major postoperative complications occurred in 40 cases (15.3%). In the multivariate analysis, SAS (odds ratio [OR], 0.42; P < 0.01), CONUT (OR, 1.39; P < 0.01), and operative time (OR, 1.42; P < 0.01) were significant independent risk factors of major complications. The area under the SAS curve was 0.852 in the receiver operating characteristic curve analysis. Postoperative hospitalization duration was significantly longer in major complications group. Evaluating preoperative nutritional condition and intraoperative hemodynamics with CONUT score and SAS was useful for predicting major postoperative complications of cervical spine surgery. In addition, both scoring measurements are easily calculated, objective evaluations. Perioperative management utilizing those scoring measurements may help prevent them.

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Predicting Trends in Cervical Spinal Surgery in the United States from 2020 to 2040

Cited by 92 publications

References 33 publications

Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates

Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates

Cost-effectiveness of anterior surgical decompression surgery for cervical degenerative disk disease: a systematic review of economic evaluations

Surgical Apgar Score and Controlling Nutritional Status Score are significant predictors of major complications after cervical spine surgery

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