6 spine studies to know


From long-term disc replacement outcomes to outpatient spine case volume, here are six studies Becker's reported about since April 1.

1. Outpatient spine procedures grew among Medicare patients between 2010 and 2021, with significant yearly growth at ASCs, according to a study in the March 2024 issue of the North American Spine Society Journal. Researchers conducted a cross-sectional study of Medicare billing database information for spine procedures between 2010 to 2021 to measure changes in outpatient volume in the Medicare population. The total number of outpatient spine procedures rose about 193% from 2010 to 2021.

2. Although the cost of cervical disc replacement and anterior cervical discectomy and fusion surgery costs are similar, long-term costs are different, according to a study in the April issue of Spine. Researchers used a commercial insurance claims database to analyze data from patients who had one- or two-level ACDF and cervical disc replacements between Jan. 1, 2017, and Dec. 31, 2017. Prices for the surgeries were similar with ACDF mean costs of $26,819, and disc replacement mean costs of $25,954. However postoperative care — which includes physical therapy, pain medication, injections, psychological treatment and additional spine surgeries — cost less for disc replacements after 30 days, 90 days and two years.

3. Synthetic interbody devices and traditional bone grafts have similar complication rates, but pseudarthrosis can be more common in patients with allografts, according to a study in the May issue of Spine. Researchers evaluated data for 11,430 patients who had one- and two-level anterior cervical discectomy and fusions with synthetic interbody devices or allograft/autografts between 2010 and 2022. The study concluded: "all-cause surgical complications are similar in patients undergoing ACDFs with synthetic interbody devices or allograft/autographs. However, the rate of pseudarthrosis appears to be higher in patients with allograft/autographs. Future prospective studies are needed to corroborate these findings."

4. Wearable technology helped assess postures in neurosurgeons during procedures to address fatigue and musculoskeletal disorders while operating, according to a study published April 19 in the Journal of Neurosurgery. Ten neurosurgeons were included — five attendings and five trainees. They wore two wearable sensors that collected the average time spent in extended, neutral and flexed static positions. Surgeons kept a static posture during 52.7% of active surgical time. During spine cases, the surgeons used an exoscope while standing and spent more time in a neutral static posture. During cranial procedures, surgeons switched between standing and sitting postures. Longer cranial procedures correlated with longer time in flexed and extended static postures.

5. Over 20 years, only 1.26% of lumbar disc replacements have needed a follow-up revision surgery or removal, spine surgeons at Texas Back Institute in Plano found. Their research, published in the May 15 issue of Spine, looked at data from 2,141 lumbar disc replacements since 2000. Of the total patients, disc removal was done in 24 patients, and 12 patients needed revisions. About 40% of removals and revisions happened in the first 25 total disc replacement cases done by individual surgeons. There was also a patient who had a "significant vascular complication" that was removed after trauma. 

6. Cervical disc replacement may have advantages over minimally invasive posterior cervical foraminotomy to treat cervical radiculopathy, according to a study published in the May 2024 issue of The Spine Journal. The study included 152 patients who had surgery for cervical radiculopathy at one institution between 2012 and 2020. 

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