Spine Research Foundation, Santa Monica, CA, USA.
Spine (Phila Pa 1976). 2012 Jan 1;37(1):67-76. doi: 10.1097/BRS.0b013e31820cccfb.
Epidemiological study using national administrative data.
To provide a complete analysis of national trends in spinal fusion from 1998 to 2008 and compare with trends in laminectomy, hip replacement, knee arthroplasty, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft.
Previous studies have reported a rapid increase in volume of spinal fusions in the United States prior to 2001, but limited reports exist beyond this point, analyzing all spinal fusion procedures collectively.
Data were obtained from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample for the years 1998 to 2008. Discharges were identified using International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes for the following procedures: spinal fusion, laminectomy, hip replacement, knee arthroplasty, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft. Population-based utilization rates were calculated from the US census data.
Between 1998 and 2008, the annual number of spinal fusion discharges increased 2.4-fold (137%) from 174,223 to 413,171 (P < 0.001). In contrast, during the same time period, laminectomy, hip replacement, knee arthroplasty, and percutaneous coronary angioplasty yielded relative increases of only 11.3%, 49.1%, 126.8%, and 38.8% in discharges, while coronary artery bypass graft experienced a decrease of 40.1%. Between 1998 and 2008, mean age for spinal fusion increased from 48.8 to 54.2 years (P < 0.001), in-hospital mortality rate decreased from 0.29% to 0.25% (P < 0.01), and mean total hospital charges associated with spinal fusion increased 3.3-fold (P < 0.001). The national bill for spinal fusion increased 7.9-fold (P < 0.001).
Frequency, utilization, and hospital charges of spinal fusion have increased at a higher rate than other notable inpatient procedures, as seen in this study from 1998 to 2008. In addition, patient demographics and hospital characteristics changed significantly; in particular, whereas the average age for spinal fusion increased, the in-hospital mortality rate decreased.
使用国家行政数据进行的流行病学研究。
全面分析 1998 年至 2008 年脊柱融合术的全国趋势，并与椎板切除术、髋关节置换术、膝关节置换术、经皮腔内冠状动脉成形术和冠状动脉旁路移植术的趋势进行比较。
先前的研究报告称，在美国，2001 年之前脊柱融合术的数量迅速增加，但此后仅限于对所有脊柱融合术进行综合分析的有限报告。
数据来自 1998 年至 2008 年医疗保健成本和利用项目全国住院患者样本。通过国际疾病分类，第九修订版，临床修正程序代码识别以下程序的出院情况：脊柱融合术、椎板切除术、髋关节置换术、膝关节置换术、经皮腔内冠状动脉成形术和冠状动脉旁路移植术。基于人口的使用率是根据美国人口普查数据计算得出的。
在 1998 年至 2008 年期间，脊柱融合术出院人数从 174223 例增加到 413171 例，增加了 2.4 倍（137%）（P <0.001）。相比之下，在同一时期，椎板切除术、髋关节置换术、膝关节置换术和经皮冠状动脉成形术的出院人数仅分别增加了 11.3%、49.1%、126.8%和 38.8%，而冠状动脉旁路移植术的出院人数则减少了 40.1%。1998 年至 2008 年间，脊柱融合术的平均年龄从 48.8 岁增加到 54.2 岁（P <0.001），住院死亡率从 0.29%下降到 0.25%（P <0.01），与脊柱融合术相关的平均总住院费用增加了 3.3 倍（P <0.001）。脊柱融合术的全国账单增加了 7.9 倍（P <0.001）。
在这项 1998 年至 2008 年的研究中，与其他显著的住院手术相比，脊柱融合术的频率、利用率和医院费用的增长速度更高。此外，患者人口统计学和医院特征发生了重大变化；特别是，尽管脊柱融合术的平均年龄增加，但住院死亡率下降。
