Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA.
Clin Spine Surg. 2020 Jun;33(5):E226-E230. doi: 10.1097/BSD.0000000000000904.
Although the incidence of spinal fusions has increased significantly in the United States over the last quarter century, national trends of anterior lumbar interbody fusion (ALIF) utilization are not known.
The objective of this study was to characterize trends, clinical characteristics, risk factors associated with, and outcomes of ALIF in the United States.
This was an epidemiological study using national administrative data from the MarketScan database.
Using a large administrative database, we identified adults who underwent ALIF in the United States from 2007 to 2014. The incidence of ALIF was studied longitudinally over time and across geographic regions in the United States. Data related to postoperative complications, length of stay, readmission, and cost were collected.
We identified 49,945 patients that underwent ALIF in the United States between 2007 and 2014. The total number of ALIF procedures increased from 3650 in 2007 to 6151 in 2014, accounting for an average increase of 24.07% annually. The Southern United States performed the highest number of ALIFs. The most common conditions treated were degenerative disc disease and spondylolisthesis. Over one third of patients (34.6%) underwent multilevel fusion. The most common complications were iron deficiency anemia, urinary tract infections, and pulmonary complications. Hospital and physician pay increased significantly during the study period.
For the first time in our knowledge, we identified national trends in ALIF utilization, outcomes, and cost using a large administrative database. Our study reaffirms prior work that has demonstrated low rates of complications, mortality, and readmission following ALIF.
Level III.
尽管在过去的四分之一个世纪里，美国的脊柱融合术发病率显著增加，但目前尚不清楚美国前路腰椎间融合术（ALIF）的应用趋势。
本研究旨在描述美国 ALIF 的趋势、临床特征、与 ALIF 相关的风险因素以及结局。
这是一项使用 MarketScan 数据库中全国行政数据的流行病学研究。
我们使用大型行政数据库，在美国确定了 2007 年至 2014 年间接受 ALIF 的成年人。随着时间的推移和美国不同地理区域对 ALIF 的发生率进行了纵向研究。收集了与术后并发症、住院时间、再入院和成本相关的数据。
我们在美国确定了 2007 年至 2014 年间进行 ALIF 的 49945 例患者。ALIF 手术数量从 2007 年的 3650 例增加到 2014 年的 6151 例，平均每年增加 24.07%。美国南部地区进行的 ALIF 数量最多。最常见的治疗疾病是退行性椎间盘疾病和脊椎滑脱症。超过三分之一的患者（34.6%）进行了多节段融合。最常见的并发症是缺铁性贫血、尿路感染和肺部并发症。在研究期间，医院和医生的薪酬显著增加。
我们首次使用大型行政数据库确定了 ALIF 应用、结果和成本的全国趋势。我们的研究再次证实了先前的工作，即表明 ALIF 后并发症、死亡率和再入院率较低。
III 级。
