A study published in Spine examines trends in three different surgical treatments for thoracic disc disorders for patients with myelopathy.
The study examines anterior/anterolateral decompression and spinal fusion; posterior/posterolateral decompression and spinal fusion; and disc decompression/excision without fusion for patients with cervical myelopathy. The researchers used the Nationwide Inpatient Sample database to identify patients for the study who underwent surgery from 2000 to 2010.
There were 13,837 patients included in the study. Here are eight trends on treatment for patients with thoracic disc disorders with myelopathy:
1. Treatment shifted substantially from disc decompression/excision without fusion to posterior/posterolateral decompression and spinal fusion. In 2000, around two-thirds of patients underwent DDE treatment; by 2010, nearly half of the patients underwent PSF.
2. Younger patients were more likely to undergo anterior/anterolateral decompression and spinal fusion. These patients also had significantly higher rates of private insurance than other groups.
3. Disc decompression/excision was performed significantly more frequently at non-teaching hospitals.
4. The highest complication rate was among the patients who underwent anterior/anterolateral decompression with fusion. Their complication rate was 24.2 percent.
5. Among patients who underwent ASF, the most common complications were pulmonary and cardiac.
6. Patients who underwent anterior/anterolateral decompression with fusion also had the highest mortality rate. The mortality rate for ASF was 2.8 fold greater than disc decompression/excision without fusion patients; it was two-fold greater than the posterior/posterolateral patients.
7. Patients undergoing the disc decompression/excision without fusion reported significantly shorter hospital length of stay and lower total hospital charges.