National Trends in Ambulatory Surgery for Intervertebral Disc Disorders and Spinal Stenosis: A 12-Year Analysis of the National Surveys of Ambulatory Surgery.
METHODS
A descriptive epidemiology study.


OBJECTIVE
The aim of this study is to investigate changes in the utilization of ambulatory surgical procedures performed for intervertebral disc disorders and spinal stenosis between 1994 and 2006 in the United States.


BACKGROUND
Understanding trends in the utilization of ambulatory spine surgery may improve health care delivery in the Unites States. Epidemiologic studies evaluating national practice patterns for ambulatory spine surgery are limited.


METHODS
The National Survey of Ambulatory Surgery conducted in 1994, 1996, and 2006 by the Centers for Disease Control and Prevention was analyzed to identify surgically managed patients with intervertebral disc disorders and spinal stenosis. Patients were divided into 1 of 3 groups: discectomy, laminectomy, or fusion. The data were analyzed for trends in demographics, treatment, and utilization.


RESULTS
Between 1994 and 2006, the number of procedures increased by 540% for intervertebral disc disorders (6.1/100 000 capita to 34.2/100 000 capita) and 926% for spinal stenosis (0.38/100 000 capita to 3.46 per 100 000 capita). Intervertebral fusions increased from 5% of outpatient spine surgeries in 1994 to 17% in 2006. The utilization of freestanding ambulatory facilities as the location of surgery increased 340% for intervertebral disc disorders and more than 2000% for stenosis. Private insurance was the largest compensator, representing 91% of cases in 2006. An increasing proportion of females underwent surgery for intervertebral disc disorders and stenosis at these ambulatory facilities over this time period. Lumbar disc displacement remained the most common diagnosis at each time point.


CONCLUSIONS
The rate of ambulatory surgery for intervertebral disc disorders and spinal stenosis increased dramatically between 1994 and 2006 based upon the National Survey of Ambulatory Surgery data, which are the most up-to-date ambulatory surgery data available. These findings may aid policy-makers and caregivers in allocating health care resources to ensure the delivery of quality patient care.


METHODS
N/A.
*University of Miami Miller School of Medicine, Miami, Florida †The Department of Rehabilitation and Orthopaedics, University of Miami Miller School of Medicine, Miami, Florida.
Matthew J
MJ
Best
Leonard T
LT
Buller
Frank J
FJ
Eismont
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data*; D017586:Diskectomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery*; D007796:Laminectomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000453:epidemiology / Q000601:surgery*; D014481:United States / Q000453:epidemiology