National trends in spinal fusion for cervical spondylotic myelopathy.

Background: The objective of this study is to provide a retrospective analysis using an NIS database to examine national trends in outcomes for CSM from 1993 to 2002.

Methods: Data for CSM admissions (n = 138792) were extracted from the 1993 to 2002 NIS database to determine overall outcomes, as well as for those patients with CSM who underwent spinal fusion. Data from 1993 to 1997 (period 1) were compared with data from 1998 to 2002 (period 2).

Results: The number of patients admitted with CSM increased 2-fold from 3.73 to 7.88 per 100000 US population. Approximately 10% of patients were admitted from the ED and 42% underwent spinal fusion. The number of patients with CSM that underwent spinal fusion increased 7-fold from 0.6 to 4.1 per 100000 people over the period from 1993 to 2002. Most spinal fusions were performed in the 45- to 64-year age group. The number of patients with 2 or more comorbidities increased from 20% to 37%; however, the mortality and adverse outcome rates remained stable, and there was a slight decrease in LOS.

Conclusions: Cervical spondylotic myelopathy is one of the most common disorders treated by spine surgeons. There was a nearly 7-fold increase in the number of spinal fusions for CSM from 1993 to 2002. Despite continued increases in patient medical comorbidities, overall complication rates have remained stable at approximately 10.3% and mortality rates constant at 0.6%.