title: Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009.
abstract: METHODS
  Retrospective analysis of a population-based database.
  
  
  OBJECTIVE
  To investigate national epidemiological trends of cervical spine surgical procedures from 2002-2009.
  
  
  BACKGROUND
  Anterior cervical fusion (ACF), posterior cervical fusion (PCF), and posterior cervical decompression (PCD) are procedures routinely performed for cervical degenerative pathology. Studies regarding epidemiological trends of these procedures is currently lacking in the literature.
  
  
  METHODS
  Data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project was obtained for each year between 2002 and 2009. Patients undergoing ACF, PCF, and PCD for the diagnosis of cervical radiculopathy and myelopathy were identified. Demographics, costs, and mortality were assessed in the surgical subgroups. A P value of 0.001 was used to denote significance. RESULTS.: An estimated 1,323,979 cervical spine surgical procedures were performed between 2002 and 2009. There was a significant upward trend in the mean age of patients undergoing cervical spine surgery during this time period. ACF and PCF cohorts demonstrated statistically significant increases in comorbidities and costs from 2002-2009. The PCF group had the greatest mortality, comorbidities, costs, and longest hospitalizations compared with ACF and PCF cohorts across all time periods.
  
  
  CONCLUSIONS
  Our study demonstrates that cervical spine surgical procedures have increased between 2002 and 2009 (P = 0.001). The primary increase in volume is due to the increasing number of ACFs. Despite older patients with more comorbidities undergoing ACF and PCF procedures, mortality has not changed. However, this patient population trended significant increases in costs during this time period. We hypothesize that these increased costs are due to an increased comorbidity burden in patients undergoing ACF or PCF. Results of this study can be used to set benchmarks for future epidemiological investigations in cervical spine surgery.
  
  
  METHODS
  4.
authors: Penn State University Medical Center, Hershey, PA, USA.
authors: Matthew
authors: M
authors: Oglesby
authors: Steven J
authors: SJ
authors: Fineberg
authors: Alpesh A
authors: AA
authors: Patel
authors: Miguel A
authors: MA
authors: Pelton
authors: Kern
authors: K
authors: Singh
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D013123:Spinal Fusion / Q000191:economics / Q000379:methods*; D014481:United States / Q000453:epidemiology