2002 年至 2009 年退行性疾病颈椎手术的流行病学趋势。
Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009.
机构信息
Penn State University Medical Center, Hershey, PA, USA.
出版信息
Spine (Phila Pa 1976). 2013 Jun 15;38(14):1226-32. doi: 10.1097/BRS.0b013e31828be75d.
STUDY DESIGN
Retrospective analysis of a population-based database.
OBJECTIVE
To investigate national epidemiological trends of cervical spine surgical procedures from 2002-2009.
SUMMARY OF BACKGROUND DATA
Anterior cervical fusion (ACF), posterior cervical fusion (PCF), and posterior cervical decompression (PCD) are procedures routinely performed for cervical degenerative pathology. Studies regarding epidemiological trends of these procedures is currently lacking in the literature.
METHODS
Data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project was obtained for each year between 2002 and 2009. Patients undergoing ACF, PCF, and PCD for the diagnosis of cervical radiculopathy and myelopathy were identified. Demographics, costs, and mortality were assessed in the surgical subgroups. A P value of 0.001 was used to denote significance. RESULTS.: An estimated 1,323,979 cervical spine surgical procedures were performed between 2002 and 2009. There was a significant upward trend in the mean age of patients undergoing cervical spine surgery during this time period. ACF and PCF cohorts demonstrated statistically significant increases in comorbidities and costs from 2002-2009. The PCF group had the greatest mortality, comorbidities, costs, and longest hospitalizations compared with ACF and PCF cohorts across all time periods.
CONCLUSION
Our study demonstrates that cervical spine surgical procedures have increased between 2002 and 2009 (P = 0.001). The primary increase in volume is due to the increasing number of ACFs. Despite older patients with more comorbidities undergoing ACF and PCF procedures, mortality has not changed. However, this patient population trended significant increases in costs during this time period. We hypothesize that these increased costs are due to an increased comorbidity burden in patients undergoing ACF or PCF. Results of this study can be used to set benchmarks for future epidemiological investigations in cervical spine surgery.
LEVEL OF EVIDENCE
研究设计
基于人群的数据库回顾性分析。
目的
调查 2002-2009 年颈椎手术的全国流行病学趋势。
背景资料概要
前路颈椎融合术（ACF）、后路颈椎融合术（PCF）和后路颈椎减压术（PCD）是用于治疗颈椎退行性病变的常规手术。目前文献中缺乏这些手术的流行病学趋势研究。
方法
从医疗保健成本和利用项目的全国住院患者样本中获取 2002 年至 2009 年每年的数据。确定诊断为颈椎神经根病和颈椎病而行 ACF、PCF 和 PCD 的患者。评估手术亚组的人口统计学、成本和死亡率。使用 P 值 0.001 表示显著性。
结果
2002 年至 2009 年期间，估计有 1323979 例颈椎脊柱手术。在此期间，接受颈椎脊柱手术的患者平均年龄呈显著上升趋势。ACF 和 PCF 队列在 2002-2009 年期间显示出合并症和成本的统计学显著增加。与 ACF 和 PCF 队列相比，PCF 组在所有时间段的死亡率、合并症、成本和最长住院时间最高。
结论
我们的研究表明，2002 年至 2009 年期间，颈椎脊柱手术数量有所增加（P = 0.001）。数量的主要增加是由于 ACF 的数量增加。尽管患有更多合并症的老年患者接受 ACF 和 PCF 手术，但死亡率没有变化。然而，在此期间，该患者人群的成本呈显著增加趋势。我们假设，这些增加的成本是由于接受 ACF 或 PCF 手术的患者合并症负担增加所致。本研究的结果可用于为未来颈椎脊柱手术的流行病学研究设定基准。
证据水平
4。
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