Journal ArticleDOI
Trends, Complications, and Costs for Hospital Admission and Surgery for Lumbar Spinal Stenosis.
Gustavo C Machado,Christopher G. Maher,Paulo H. Ferreira,Ian A. Harris,Richard A. Deyo,Damien McKay,Qiang Li,Manuela L. Ferreira +7 more
Reads0
Chats0
TLDR
In Australia, decompression rates for lumbar spinal stenosis increased from 2003 to 2013, and the fastest increasing surgical procedure was complex fusion, which increased the risk of major complications and resource, although recent evidence suggest fusion provides no additional benefits to the traditional decompression surgery.Abstract:
Population based health record linkage study.
To determine trends in hospital admissions and surgery for lumbar spinal stenosis, as well as complications and resource use in Australia.
In the United States, rates of decompression surgery have declined, whereas those of fusion have increased. It is unclear whether this trend is also happening elsewhere.
We included patients 18 years and older admitted to a hospital in New South Wales between 2003–2013, who were diagnosed with lumbar spinal stenosis. We investigated the rates of hospital admission and surgical procedures, as well as hospital costs, length of hospital stay, and complications. Surgical procedures were: decompression alone, simple fusion (1–2 disc levels, single approach), and complex fusion (≥3 disc levels or a combined posterior and anterior approach).
The rates of decompression surgery increased from 19.0 to 22.1 per 100,000 people. Simple fusion rates increased from 1.3 to 2.8 per 100,000 people, while complex fusion increased from 0.6 to 2.4 per 100,000 people. The odds of major complications for complex fusion compared with decompression alone was 4.1 (95% CI: 1.7–10.1), though no difference was found for simple fusion (OR 2.0, 95% CI: 0.7–6.1). Mean hospital costs with decompression surgery were AU $12,168, while simple and complex fusion cost AU $30,811 and AU $32,350, respectively.
In Australia, decompression rates for lumbar spinal stenosis increased from 2003–2013. The fastest increasing surgical procedure was complex fusion. This procedure increased the risk of major complications and resource, though recent evidence suggest fusion provides no additional benefits to the traditional decompression surgery.
Level of Evidence: 3read more
Citations
More filters
Journal ArticleDOI
Prevention and treatment of low back pain: evidence, challenges, and promising directions.
Nadine E. Foster,Johannes R. Anema,Dan Cherkin,Roger Chou,Steven P. Cohen,Steven P. Cohen,Douglas P. Gross,Paulo H. Ferreira,Julie M. Fritz,Bart W. Koes,Wilco C. Peul,Judith A. Turner,Christopher G. Maher,Rachelle Buchbinder,Jan Hartvigsen,Martin Underwood,Maurits W. van Tulder,Stephen P Cohen,Lucíola da Cunha Menezes Costa,Peter Croft,Manuela L. Ferreira,Stéphane Genevay,Mark J. Hancock,Damian G Hoy,Jaro Karppinen,Alice Kongsted,Quinette Louw,Birgitta Öberg,Wilco C. Peul,Glenn Pransky,Mark L. Schoene,Joachim Sieper,Rob J. E. M. Smeets,Anthony D. Woolf +33 more
TL;DR: Effective, promising, or emerging solutions that could offer new directions in the management of low back pain need greater attention and further research to determine if they are appropriate for large-scale implementation.
Journal ArticleDOI
Lumbar Spinal Stenosis in Older Adults
TL;DR: Lumbar spinal stenosis is a frequent cause of low back pain among adults, caused by a narrowing impinging on the spinal cord or nerve roots, and has no significant benefit over more conservative options.
Journal ArticleDOI
Lumbar spine fusion: what is the evidence?
Ian A. Harris,Ian A. Harris,Adrian C Traeger,Ralph Stanford,Christopher G. Maher,Rachelle Buchbinder +5 more
TL;DR: No high‐quality systematic reviews were found and the risk of bias of the randomised controlled trials in the reviews was generally high, meaning better evidence is required to determine more accurately the effectiveness of spine fusion surgery for all indications.
Journal Article
Comprehensive Evidence-Based Guidelines for Facet Joint Interventions in the Management of Chronic Spinal Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines Facet Joint Interventions 2020 Guidelines.
Laxmaiah Manchikanti,Alan D. Kaye,Amol Soin,Sheri L. Albers,Douglas P. Beall,Richard E. Latchaw,Mahendra R Sanapati,Shalini Shah,Sairam Atluri,Alaa Abd-Elsayed,Salahadin Abdi,Steve M. Aydin,Sanjay Bakshi,Mark V. Boswell,Ricardo M. Buenaventura,Joseph A Cabaret,Aaron K. Calodney,Kenneth D. Candido,Paul J. Christo,Lynn Cintron,Sudhir Diwan,Christopher Gharibo,Jay S. Grider,Mayank Gupta,Bill Haney,Michael E. Harned,Standiford Helm,Jessica Jameson,Sunny Jha,Adam M. Kaye,Nebojsa Nick Knezevic,Radomir Kosanovic,Maanasa V Manchikanti,Annu Navani,Gabor B. Racz,Vidyasagar Pampati,Ramarao Pasupuleti,Cyril Philip,Kartic Rajput,Nalini Sehgal,Gururau Sudarshan,Rachana Vanaparthy,Bradley W. Wargo,Joshua A Hirsch +43 more
TL;DR: A review of the literature pertaining to all aspects of facet joint interventions, with a best evidence synthesis of available literature and utilizing grading for recommendations, is presented in this article, where the authors developed objectives and key questions with utilization of trustworthy standards.
Journal ArticleDOI
Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis
Niek Koenders,Alison Rushton,Martin L. Verra,Paul C. Willems,Thomas J. Hoogeboom,J.B. Staal,J.B. Staal +6 more
TL;DR: There is a substantial improvement in pain and disability after first-time LSF for degenerative disorders, however, long-term outcomes indicate that leg pain might be more reduced and for a longer period of time than axial back pain and Disability.
References
More filters
Journal ArticleDOI
Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.
Hude Quan,Vijaya Sundararajan,Patricia Halfon,Andrew Fong,Bernard Burnand,Jean-Christophe Luthi,L. Duncan Saunders,Cynthia A. Beck,Thomas E Feasby,William A. Ghali +9 more
TL;DR: A multistep process to develop ICD-10 coding algorithms to define Charlson and Elixhauser comorbidities in administrative data and assess the performance of the resulting algorithms found these newly developed algorithms produce similar estimates ofComorbidity prevalence in administrativeData, and may outperform existing I CD-9-CM coding algorithms.
Journal ArticleDOI
Rehospitalizations among Patients in the Medicare Fee-for-Service Program
TL;DR: Rehospitalizations among Medicare beneficiaries are prevalent and costly and about 10% of rehospitalizations were likely to have been planned.
Journal ArticleDOI
Trends, Major Medical Complications, and Charges Associated with Surgery for Lumbar Spinal Stenosis in Older Adults
Richard A. Deyo,Sohail K. Mirza,Brook I. Martin,William Kreuter,David C. Goodman,Jeffrey G. Jarvik +5 more
TL;DR: Examining trends in use of different types of stenosis operations and the association of complications and resource use with surgical complexity found that in 2007, compared with decompression, simple fusion and complex fusion were associated with increased risk of major complications, 30-day mortality, and resourceUse.
Journal ArticleDOI
Lumbar Spinal Stenosis
TL;DR: A 72-year-old woman with hypertension presents with a 4-month history of lower back discomfort that radiates to both buttocks and lateral thighs that is notable only for a slightly stooped posture and a reduction of vibratory sensibility in both great toes.
Journal ArticleDOI
An Assessment of Surgery for Spinal Stenosis: Time Trends, Geographic Variations, Complications, and Reoperations
TL;DR: To study temporal trends and geographic variations in the use of surgery for spinal stenosis, estimate short‐term morbidity and mortality of the procedure, and examine the likelihood of repeat back surgery after surgical repair.