National Trends in the Use of Fusion Techniques to Treat Degenerative Spondylolisthesis
- 1 September 2014
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Spine
- Vol. 39 (19), 1584-1589
- https://doi.org/10.1097/brs.0000000000000486
Abstract
Retrospective review. (1) To describe change in treatment patterns for degenerative spondylolisthesis (DS). (2) To report regional variation in treatment of DS. (3) To describe variation in surgeon-reported outcomes for DS based on treatment. Spinal stenosis associated with DS is commonly treated with decompression and fusion but little is known about the optimal fusion technique. During a 6-month period, American Board of Orthopaedic Surgery step II candidates submit procedure lists; these lists have been stored in an electronic database since 1999. The American Board of Orthopaedic Surgery database was retrospectively queried to identify patients who underwent surgery for DS from 1999 to 2011. Included patients underwent uninstrumented fusion, fusion with posterior instrumentation, fusion using interbody device, or decompression without fusion. Utilization of these procedures was analyzed by year and geographic region. The study period included 5639 cases; the annual number of cases doubled during the study period. The percentage of cases treated with interbody fusion (IF) increased significantly throughout the study period, from 13.6% (1999-2001) to 32% (2009-2011) (P10% higher than any other region (P<0.001) and more than 23% higher than the Southeast (P<0.001). Despite little evidence guiding treatment strategy for DS, national treatment patterns have changed dramatically during the past 13 years. The rapid adoption of IF and substantial regional variation in treatment utilization patterns raises questions about drivers of change including perceptions about associated fusion rates, the importance of sagittal balance and differential reimbursement. 4.Keywords
This publication has 17 references indexed in Scilit:
- Comparison of ICD-9–based, retrospective, and prospective assessments of perioperative complications: assessment of accuracy in reportingJournal of Neurosurgery: Spine, 2011
- Success and Failure of Minimally Invasive Decompression for Focal Lumbar Spinal Stenosis in Patients With and Without DeformitySpine, 2010
- Practice Patterns for Combined Anterior Cruciate Ligament and Meniscal Surgery in the United StatesThe American Journal of Sports Medicine, 2010
- Surgical Compared with Nonoperative Treatment for Lumbar Degenerative SpondylolisthesisJournal of Bone and Joint Surgery, 2009
- Surgical treatment of adult degenerative spondylolisthesis by instrumented transforaminal lumbar interbody fusion in the Han nationalityJournal of Neurosurgery: Spine, 2009
- Fractures of the Distal Part of the RadiusJournal of Bone and Joint Surgery, 2008
- Nail or Plate Fixation of Intertrochanteric Hip Fractures: Changing Pattern of PracticeJournal of Bone and Joint Surgery, 2008
- A Critical Analysis of the Literature Regarding Surgical Approach and Outcome for Adult Low-Grade Isthmic SpondylolisthesisJournal of Spinal Disorders & Techniques, 2005
- 1997 Volvo Award Winner in Clinical StudiesSpine, 1997
- L4-5 Degenerative SpondylolisthesisSpine, 1989