8 Trends for Surgical Management of Lumbar Spinal Stenosis


Researchers led by Hyun Bae, MD, a spine surgeon with Cedars-Sinai Medical Center in Los Angeles, examined patients who underwent surgery for lumbar spinal stenosis from 2004 to 2009 from the Nationwide Inpatient Sample, a database developed as part of the Healthcare Cost and Utilization Project, and the findings were published in Spine.
The researchers studied patients with lumbar spinal stenosis alone, with spondylolisthesis and with scoliosis. Treatment included decompression only, simple fusion and complex fusion. The trends included:

•    Annual number of patients discharged inpatient with the primary diagnosis of lumbar spinal stenosis increased from 94,011 to 102,107.
•    Rate of decompressions decreased during that time period from 58.5 percent to 49.2 percent.
•    Simple fusions for these patients increased from 21.5 percent to 31.2 percent
•    Complex fusion rates for these patients did not change — they remained at 6.7 percent.
•    Bone morphogenic protein use doubled from 2004 to 2009, from 14.5 percent to 33 percent of all fusions.
•    Interbody device use also increased in these patients from 28.5 percent to 45.1 percent.
•    According to the report, in 2009 26.2 percent of patients with lumbar spinal stenosis without instability underwent fusion procedures.
•    In 2009, 82.7 percent of patients with lumbar spinal stenosis and spondylolisthesis underwent fusion and 67.6 percent of patients with lumbar spinal stenosis and scoliosis underwent fusions.

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