Our Summary

This research paper analyzed data from New York State between 1997 and 2012 to study trends in cervical spinal fusion surgeries (operations where parts of the neck spine are joined together). During this period, the rate of these surgeries more than doubled. While the rates remained steady among younger patients, they increased for older individuals. These surgeries were mainly performed due to degenerative conditions (conditions that worsen over time), and the rate of these conditions rose over time.

There are different ways to perform these surgeries: from the front (anterior), from the back (posterior), or from both sides (circumferential). The study found that most surgeries were done from the front (85.2%), followed by from the back (12.3%), and then both sides (2.5%).

The average age of patients varied depending on the type of surgery: 49.8 years for anterior, 59.9 years for posterior, and 55.1 years for circumferential.

The length of the hospital stay also varied depending on the surgery type: 3.1 days for anterior, 9.1 days for posterior, and 14.1 days for circumferential.

Likewise, the rates of complications and deaths were different for each type. The lowest rates were seen in the anterior approach (3.0% complications, 0.3% deaths), followed by the posterior (10.5% complications, 1.8% deaths), and the highest rates were seen in the circumferential approach (18.9% complications, 2.5% deaths).

In conclusion, the study found that the rate of cervical spinal fusions has significantly increased, especially in older patients. The type of surgery approach had a significant impact on the age of the patient, hospital stay, and risk of complications and death, with anterior fusion showing the best short-term outcomes.

FAQs

  1. What trends were identified in cervical spinal fusion surgeries from 1997 to 2012?
  2. How does the type of surgical approach impact the patient’s hospital stay and risk of complications and death in cervical spinal fusion surgeries?
  3. Did the rate of cervical spinal fusion surgeries increase for all age groups over the studied period?

Doctor’s Tip

A helpful tip a doctor might give a patient considering spinal fusion surgery is to discuss the different surgical approaches with their healthcare provider to determine the best option for their specific condition. It is important to understand the potential risks and benefits of each approach, as well as the expected recovery time and outcomes. Additionally, patients should follow their doctor’s post-operative instructions carefully to promote healing and reduce the risk of complications. Regular follow-up appointments with the healthcare team are essential for monitoring progress and addressing any concerns that may arise.

Suitable For

Patients who are typically recommended for spinal fusion surgeries are those with degenerative conditions of the spine, such as degenerative disc disease, spinal stenosis, or spondylolisthesis. These conditions can cause symptoms such as chronic neck or back pain, numbness or weakness in the arms or legs, and difficulty walking. Patients who have not found relief from conservative treatments such as physical therapy, medications, or injections may be candidates for spinal fusion surgery. Additionally, patients with spinal instability or deformities, such as scoliosis, may also be recommended for spinal fusion to stabilize the spine and prevent further progression of the condition. It is important for patients to discuss the risks and benefits of spinal fusion surgery with their healthcare provider to determine if it is the right treatment option for their specific condition.

Timeline

Before spinal fusion surgery, a patient may experience chronic neck or back pain, weakness or numbness in the arms or legs, difficulty walking or standing, and limited range of motion in the neck or back. They may have already tried conservative treatments such as physical therapy, medication, or injections without success.

After spinal fusion surgery, the patient will typically need to stay in the hospital for a few days to a couple of weeks, depending on the type of surgery performed. They will need to follow a strict post-operative rehabilitation program to help with pain management, mobility, and strengthening the muscles surrounding the spine. It can take several weeks to months to fully recover from spinal fusion surgery, and the patient may need to avoid certain activities or movements to prevent complications. Over time, the patient should experience a reduction in pain and improvement in their overall quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion include:

  1. What type of spinal fusion surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the typical recovery time for this type of surgery?
  4. What are the expected outcomes and benefits of the surgery?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How many of these surgeries have you performed, and what is your success rate?
  7. Are there any alternative treatments or less invasive procedures that I could consider?
  8. What is the expected timeline for returning to normal activities after the surgery?
  9. Will I need to make any lifestyle changes or modifications after the surgery?
  10. What can I do to help ensure a successful outcome and minimize the risk of complications?

Reference

Authors: Salzmann SN, Derman PB, Lampe LP, Kueper J, Pan TJ, Yang J, Shue J, Girardi FP, Lyman S, Hughes AP. Journal: World Neurosurg. 2018 May;113:e280-e295. doi: 10.1016/j.wneu.2018.02.004. Epub 2018 Feb 10. PMID: 29438790