Complications and mortality associated with cervical spine surgery for degenerative disease in the United States

Marjorie C. Wang, Leighton Chan, Dennis J. Maiman, William Kreuter, Richard (Rick) Deyo

Research output: Contribution to journalArticle

194 Citations (Scopus)

Abstract

STUDY DESIGN. Retrospective cohort. OBJECTIVES. To describe the incidence of complications and mortality associated with surgery for degenerative disease of the cervical spine using population-based data. To evaluate the associations between complications and mortality and age, primary diagnosis and type of surgical procedure. SUMMARY OF BACKGROUND DATA. Recent studies have shown an increase in the number of cervical spine surgeries performed for degenerative disease in the United States. However, the associations between complications and mortality and age, primary diagnosis and type of surgical procedure are not well described using population-based data. METHODS. We created an algorithm defining degenerative cervical spine disease and associated complications using the International Classification of Diseases-ninth revision Clinical Modification codes. Using the Nationwide Inpatient Sample, we determined the primary diagnoses, surgical procedures, and associated in-hospital complications and mortality from 1992 to 2001. RESULTS. From 1992 to 2001, the Nationwide Inpatient Sample included an estimated 932,009 (0.3%) hospital discharges associated with cervical spine surgery for degenerative disease. The majority of admissions were for herniated disc (56%) and cervical spondylosis with myelopathy (19%). Complications and mortality were more common in the elderly, and after posterior fusions or surgical procedures associated with a primary diagnosis of cervical spondylosis with myelopathy. CONCLUSIONS. There are significant differences in outcome associated with age, primary diagnosis, and type of surgical procedure. Administrative databases may underestimate the incidence of complications, but these population-based studies may provide information for comparison with surgical case series and help evaluate rare or severe complications.

Original languageEnglish (US)
Pages (from-to)342-347
Number of pages6
JournalSpine
Volume32
Issue number3
DOIs
StatePublished - Feb 2007
Externally publishedYes

Fingerprint

Spine
Mortality
Spondylosis
Spinal Cord Diseases
Inpatients
Population
Intervertebral Disc Displacement
Incidence
International Classification of Diseases
Hospital Mortality
Databases

Keywords

  • Cervical spine surgery
  • Complications
  • Degenerative disease
  • Elderly
  • Epidemiology
  • Mortality
  • Outcomes

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Complications and mortality associated with cervical spine surgery for degenerative disease in the United States. / Wang, Marjorie C.; Chan, Leighton; Maiman, Dennis J.; Kreuter, William; Deyo, Richard (Rick).

In: Spine, Vol. 32, No. 3, 02.2007, p. 342-347.

Research output: Contribution to journalArticle

Wang, Marjorie C. ; Chan, Leighton ; Maiman, Dennis J. ; Kreuter, William ; Deyo, Richard (Rick). / Complications and mortality associated with cervical spine surgery for degenerative disease in the United States. In: Spine. 2007 ; Vol. 32, No. 3. pp. 342-347.
@article{48b08a726f0d4fe09f476e7caf8e9689,
title = "Complications and mortality associated with cervical spine surgery for degenerative disease in the United States",
abstract = "STUDY DESIGN. Retrospective cohort. OBJECTIVES. To describe the incidence of complications and mortality associated with surgery for degenerative disease of the cervical spine using population-based data. To evaluate the associations between complications and mortality and age, primary diagnosis and type of surgical procedure. SUMMARY OF BACKGROUND DATA. Recent studies have shown an increase in the number of cervical spine surgeries performed for degenerative disease in the United States. However, the associations between complications and mortality and age, primary diagnosis and type of surgical procedure are not well described using population-based data. METHODS. We created an algorithm defining degenerative cervical spine disease and associated complications using the International Classification of Diseases-ninth revision Clinical Modification codes. Using the Nationwide Inpatient Sample, we determined the primary diagnoses, surgical procedures, and associated in-hospital complications and mortality from 1992 to 2001. RESULTS. From 1992 to 2001, the Nationwide Inpatient Sample included an estimated 932,009 (0.3{\%}) hospital discharges associated with cervical spine surgery for degenerative disease. The majority of admissions were for herniated disc (56{\%}) and cervical spondylosis with myelopathy (19{\%}). Complications and mortality were more common in the elderly, and after posterior fusions or surgical procedures associated with a primary diagnosis of cervical spondylosis with myelopathy. CONCLUSIONS. There are significant differences in outcome associated with age, primary diagnosis, and type of surgical procedure. Administrative databases may underestimate the incidence of complications, but these population-based studies may provide information for comparison with surgical case series and help evaluate rare or severe complications.",
keywords = "Cervical spine surgery, Complications, Degenerative disease, Elderly, Epidemiology, Mortality, Outcomes",
author = "Wang, {Marjorie C.} and Leighton Chan and Maiman, {Dennis J.} and William Kreuter and Deyo, {Richard (Rick)}",
year = "2007",
month = "2",
doi = "10.1097/01.brs.0000254120.25411.ae",
language = "English (US)",
volume = "32",
pages = "342--347",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Complications and mortality associated with cervical spine surgery for degenerative disease in the United States

AU - Wang, Marjorie C.

AU - Chan, Leighton

AU - Maiman, Dennis J.

AU - Kreuter, William

AU - Deyo, Richard (Rick)

PY - 2007/2

Y1 - 2007/2

N2 - STUDY DESIGN. Retrospective cohort. OBJECTIVES. To describe the incidence of complications and mortality associated with surgery for degenerative disease of the cervical spine using population-based data. To evaluate the associations between complications and mortality and age, primary diagnosis and type of surgical procedure. SUMMARY OF BACKGROUND DATA. Recent studies have shown an increase in the number of cervical spine surgeries performed for degenerative disease in the United States. However, the associations between complications and mortality and age, primary diagnosis and type of surgical procedure are not well described using population-based data. METHODS. We created an algorithm defining degenerative cervical spine disease and associated complications using the International Classification of Diseases-ninth revision Clinical Modification codes. Using the Nationwide Inpatient Sample, we determined the primary diagnoses, surgical procedures, and associated in-hospital complications and mortality from 1992 to 2001. RESULTS. From 1992 to 2001, the Nationwide Inpatient Sample included an estimated 932,009 (0.3%) hospital discharges associated with cervical spine surgery for degenerative disease. The majority of admissions were for herniated disc (56%) and cervical spondylosis with myelopathy (19%). Complications and mortality were more common in the elderly, and after posterior fusions or surgical procedures associated with a primary diagnosis of cervical spondylosis with myelopathy. CONCLUSIONS. There are significant differences in outcome associated with age, primary diagnosis, and type of surgical procedure. Administrative databases may underestimate the incidence of complications, but these population-based studies may provide information for comparison with surgical case series and help evaluate rare or severe complications.

AB - STUDY DESIGN. Retrospective cohort. OBJECTIVES. To describe the incidence of complications and mortality associated with surgery for degenerative disease of the cervical spine using population-based data. To evaluate the associations between complications and mortality and age, primary diagnosis and type of surgical procedure. SUMMARY OF BACKGROUND DATA. Recent studies have shown an increase in the number of cervical spine surgeries performed for degenerative disease in the United States. However, the associations between complications and mortality and age, primary diagnosis and type of surgical procedure are not well described using population-based data. METHODS. We created an algorithm defining degenerative cervical spine disease and associated complications using the International Classification of Diseases-ninth revision Clinical Modification codes. Using the Nationwide Inpatient Sample, we determined the primary diagnoses, surgical procedures, and associated in-hospital complications and mortality from 1992 to 2001. RESULTS. From 1992 to 2001, the Nationwide Inpatient Sample included an estimated 932,009 (0.3%) hospital discharges associated with cervical spine surgery for degenerative disease. The majority of admissions were for herniated disc (56%) and cervical spondylosis with myelopathy (19%). Complications and mortality were more common in the elderly, and after posterior fusions or surgical procedures associated with a primary diagnosis of cervical spondylosis with myelopathy. CONCLUSIONS. There are significant differences in outcome associated with age, primary diagnosis, and type of surgical procedure. Administrative databases may underestimate the incidence of complications, but these population-based studies may provide information for comparison with surgical case series and help evaluate rare or severe complications.

KW - Cervical spine surgery

KW - Complications

KW - Degenerative disease

KW - Elderly

KW - Epidemiology

KW - Mortality

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=33846655094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846655094&partnerID=8YFLogxK

U2 - 10.1097/01.brs.0000254120.25411.ae

DO - 10.1097/01.brs.0000254120.25411.ae

M3 - Article

C2 - 17268266

AN - SCOPUS:33846655094

VL - 32

SP - 342

EP - 347

JO - Spine

JF - Spine

SN - 0362-2436

IS - 3

ER -