A new study published in the Journal of Bone and Joint Surgery examines trends in single and multilevel cervical stenosis treatment.
The study authors examined 5,068 cervical spine surgeries performed by surgeons taking part in the American Board of Orthopaedic Surgery licensing exam, Part II. Surgeons performed the procedures from 1998 to 2013. Study authors found:
1. The number of procedures performed every year was relatively similar from 1998 until 2011, when there was a sudden 280 percent increase in procedures. There were 1,131 cervical spine surgeries performed in 2011, compared with 202 in 2010. Over the same time period, the number of individuals taking the exam rose 150 percent, from 42 individuals to 105 individuals.
2. The anterior approach predominated over posterior approaches in the early years and was driven by corpectomy volume, according to the report.
3. The posterior approach became more common from 2004 to 2011 and then experienced a sharp decline in 2011. The drop in 2011 was due to a large number of anterior cervical discectomies and fusions performed that year, which continued through 2013.
4. Total disc replacement and laminoplasty, along with other motion-preserving techniques, increased from 2005 to 2007, but then dropped to less than 5 percent utilization in 2014. Fusion techniques continue to dominate with more than 90 percent of procedures performed.
5. The trends discovered in this study reflect a shift to more of the orthopedic graduates choosing to subspecialize in spine surgery. "While the number of surgeons performing spine surgery has increased, the sheer number of procedures that each surgeon performed greatly outpaced the increased number of surgeons."