The use of surgery for cervical degenerative disease in Norway in the period 2008–2014

Kristiansen, Jon-André; Balteskard, Lise; Slettebø, Haldor; Nygaard, Øystein P.; Lied, Bjarne; Kolstad, Frode

doi:10.1007/s00701-016-2760-1

Cited by 19 publications

(29 citation statements)

References 29 publications

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“…Over the 17-year period, the operations for FS especially increased, while the incidence of operations for DP only slightly increased. The distribution in the diagnoses is similar to the findings from Norway, where 79% of the operations were performed for radiculopathy and 21% for myelopathy [14]. However, in a recent study of all the cervical fusions in the state of New York, 70% of the operations were found to be performed for degenerative disc, 30% for spondylosis, and only 13% for spinal stenosis [32].…”

Section: Discussionsupporting

confidence: 74%

“…Nevertheless, the estimated rate of surgery for degenerative cervical symptoms has risen steadily from the 1970s onwards until the last decade in the US [3, 9, 18, 22, 24, 26] and stabilized at between 70 and 80 operations/100,000 people [18] (a summary of the previous literature is provided in the Supplementary Table S1). A similar rise in the operation rates has been recently demonstrated in Norway as well [14]. However, systematic longitudinal nationwide incidences for the different diagnostic entities have not been reported.…”

Section: Introductionsupporting

confidence: 68%

“…The rate of surgery in Finland appears to be slightly higher than the rate found in Norway but is only 25 to 48% of the reported estimated incidence of surgery in the US which, however, are not restricted to primary operations [14, 18, 22, 24, 26]. The differences in the data sources and the inclusion criteria make direct comparisons of the rates somewhat uncertain.…”

Section: Discussionmentioning

confidence: 87%

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Surgery for degenerative cervical spine disease in Finland, 1999–2015

et al. 2019

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BackgroundThe incidence of surgery for degenerative cervical spine disease (DCSD) has risen by almost 150% in the USA in the last three decades and stabilized at slightly over 70 operations/100,000 people. There has been significant regional variation in the operation incidences. We aim to assess the diagnosis-based, age-adjusted trends in the operation incidences and the regional variation in Finland between 1999 and 2015.MethodsData from the Finnish Hospital Discharge Register (FHDR), the Cause of Death Register, and the registers of the Social Insurance Institution were combined to analyze all the primary operations for DCSD or rheumatoid atlanto-axial subluxation (rAAS). Combinations of the operative and the diagnosis codes were used to classify the patients into five diagnostic groups.ResultsA total of 19,701 primary operations were included. The age-adjusted operation incidence rose from 21.0 to 36.5/100,000 people between 1999 and 2013 and plateaued thereafter. The incidence of surgery for radiculopathy increased from 13.1 to 23.3 operations/100,000 people, and the incidence of surgery for DCM increased from 5.8 to 7.0 operations/100,000 people. The rise was especially pronounced in surgery for foraminal stenosis, which increased from 5.3 to 12.4 operations/100,000 people. Of the five diagnostic groups, only operations for rAAS declined. Operations increased especially in the 40- to 65-year-old age group. The overall operation incidences varied from 18.3 to 43.1 operations/100,000 people between the university hospitals.ConclusionsThe age-adjusted incidence of surgery for DCSD has risen in Finland by 76%, but the rise has plateaued. Surgery for radiculopathy, especially for foraminal stenosis, increased more steeply than surgery for degenerative medullopathy, with vast regional differences in the operation incidences.Electronic supplementary materialThe online version of this article (10.1007/s00701-019-03958-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 87%

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Surgery for degenerative cervical spine disease in Finland, 1999–2015

et al. 2019

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“…Anterior cervical discectomy is one of the most frequently performed spinal procedures; in the United States, almost 550,000 patients were operated on between 2005 and 2008 [13]. The surgical rates for cervical radiculopathy are lower in Norway compared to the United States, but increased by 86.5% from 2008 to 2014, and was 2.5 times higher in counties with the highest rates compared to those with the lowest rates [14]. Neither the observed increase over time nor geographical differences are likely to be explained by variations in the prevalence of cervical radiculopathy.…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy

Taso

Sommernes

Kolstad

et al. 2020

BMC Musculoskelet Disord

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Background: Cervical radiculopathy is usually caused by disc herniation or spondylosis. The prognosis is expected to be good in most patients, but there is limited scientific evidence on the indications for nonsurgical and surgical treatments. The aim of the present study is to evaluate and compare the effectiveness of surgical and nonsurgical treatment in two trialsincluding disc herniation and spondylosis, respectively, and to evaluate factors that contribute to better decision making. Methods/design: Patients with disabling radicular arm pain and MRI-proven cervical disc herniation or spondylosis will be randomised to receive nonsurgical or surgical treatment. The follow-up period is one year and the sample size is estimated to be 50 for each arm in the two trials, giving a total of 200 patients. The primary outcomes are the Neck Disability Index and arm pain. Secondary outcomes include neck pain; EQ-5D and costs to evaluate costeffectiveness; prognostic factors; CT and MRI scans, to estimate intervertebral foraminal area and nerve root compression; and the expected minimal improvement for willingness to undergo treatment. Discussion: The outcomes of this study will contribute to better decision making in the treatment of cervical radiculopathy. Trial registration: This study has been registered at ClinicalTrials.gov as NCT03674619, on September 17, 2018.

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“…According to a previous study[ 1 ], the hospitalization rates of surgical procedures for SCDD increased from an estimated 41000 to 76000 every year with a 85% increase during 1980 to 1990. In fact, there were 50–60 patients who chose surgery treatment for SCDD per 10,000 inhabitants every year[ 2 ]. Anterior cervical discectomy and fusion (ACDF) has been considered as a “gold standard” of surgical procedure for the treatment of SCDD[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

et al. 2017

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ObjectiveSymptomatic cervical disc disease (SCDD) is a common degenerative disease, and Discover artificial cervical disc, a new-generation nonconstrained artificial disk, has been developed and performed gradually to treat it. We performed this meta-analysis to compare the efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) for SCDD.MethodsAn exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials that compared DCDA with ACDF for patients suffering SCDD. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval.ResultsOf 33 articles identified, six studies were included. Compared with ACDF, DCDA demonstrated shorter operation time (P < 0.0001), and better range of motion (ROM) at the operative level (P < 0.00001). But no significant differences were observed in blood loss, neck disability index (NDI) scores, neck and arm pain scores, Japanese orthopaedic association (JOA) scores, secondary surgery procedures and adverse events (P > 0.05). Subgroup analyses did not demonstrated significant differences.ConclusionIn conclusion, DCDA presented shorter operation time, and better ROM at the operative level. However, no significant differences were observed in blood loss, NDI scores, neck and arm pain scores, JOA scores, secondary surgery procedures and adverse events between the two groups. Additionally, more studies of high quality with mid- to long-term follow-up are required in future.

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The use of surgery for cervical degenerative disease in Norway in the period 2008–2014

Abstract: Our study shows that the rate of surgical treatment for radiculopathy due to CDD has increased substantially from 2008 to 2014 for all RHAs in Norway. The incidence rate for surgical treatment of myelopathy was more stable. An unexplained and moderate geographic variation was found.

Cited by 19 publications

References 29 publications

Surgery for degenerative cervical spine disease in Finland, 1999–2015

Surgery for degenerative cervical spine disease in Finland, 1999–2015

A randomised controlled trial comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy

Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

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