Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California, United States; Department of Orthopedic Surgery, China-Japan Union Hospital, Jilin University, ChangChun City, JiLin Province, China.
Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States.
Global Spine J. 2016 Aug;6(5):422-31. doi: 10.1055/s-0035-1564416. Epub 2015 Sep 18.
Retrospective study.
Symptomatic scoliosis can be a source of severe pain and disability. When nonoperative treatments fail, spine fusion is considered as an effective procedure in scoliosis management. The purpose of this study was to evaluate the trends of patients with scoliosis undergoing posterior long segment fusion (PLSF) with and without recombinant human bone morphogenetic protein 2 (rhBMP-2).
Patients within the orthopedic subset of Medicare database undergoing PLSF from 2005 to 2011 were identified using the PearlDiver Patient Records Database. Both diagnosis and procedural International Classification of Diseases, ninth edition and Current Procedural Terminology codes were used. The year of procedure, age, sex, region, and rhBMP-2 use were recorded.
In total, 1,265,591 patients with scoliosis were identified with 29,787 PLSF surgeries between 2005 and 2011. The incidence of PLSF procedures increased gradually from 2005 to 2009, decreased in 2010 (p < 0 0.01), and grew again in 2011. Patients over age 84 years had the highest incidence of PLSF. The lowest incidence of the procedures was in the Northeast, 5.96 per 100,000 patients. Sex differences were observed with a male-to-female ratio of 0.40 (p < 0.01). The use of rhBMP-2 for PLSF increased steadily from 2005 to 2009; the numbers dropped dramatically in 2010 and returned by 2011.
According to our study, patients with scoliosis demonstrated a 0.6575 average incidence increase of PLSF treatments annually. There were significant differences in incidence of PLSF procedure and patient demographics. Additionally, rhBMP-2 consumption significantly changed when we stratified it by sex, age, and region respectively.
回顾性研究。
症状性脊柱侧凸可导致严重疼痛和残疾。当非手术治疗失败时，脊柱融合被认为是脊柱侧凸治疗的有效方法。本研究的目的是评估接受后路长节段融合（PLSF）治疗且未使用重组人骨形态发生蛋白 2（rhBMP-2）的脊柱侧凸患者的趋势。
使用 PearlDiver 患者记录数据库，从 2005 年至 2011 年，从医疗保险数据库的骨科部分确定接受 PLSF 的患者。使用诊断和程序国际疾病分类，第九版和当前程序术语代码。记录手术年份、年龄、性别、地区和 rhBMP-2 使用情况。
共确定了 1265591 例脊柱侧凸患者，2005 年至 2011 年间进行了 29787 例 PLSF 手术。PLSF 手术的发生率从 2005 年至 2009 年逐渐增加，2010 年下降（p<0.01），2011 年再次增加。84 岁以上患者的 PLSF 发生率最高。该手术的最低发生率在东北部，为每 10 万患者 5.96 例。观察到性别差异，男女比例为 0.40（p<0.01）。PLSF 中 rhBMP-2 的使用从 2005 年至 2009 年稳步增加；2010 年数量急剧下降，2011 年又恢复。
根据我们的研究，脊柱侧凸患者每年 PLSF 治疗的平均发病率增加了 0.6575。PLSF 手术的发生率和患者人口统计学特征存在显著差异。此外，当我们分别按性别、年龄和地区对 rhBMP-2 消耗进行分层时，rhBMP-2 的消耗有显著变化。
