National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression

Objective The purpose of this study is to describe utilization, demographics, complications, and revisions for patients with degenerative spondylolisthesis (DS) with stenosis undergoing decompression or decompression with fusion in the United States. Methods A national insurance database was used to...

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Main Authors: Jacob R. Ball, Matthew C. Gallo, Kareem Kebaish, Nicole Hang, Andy Ton, Fergui Hernandez, Marc Abdou, William J. Karakash, Jeffrey C. Wang, Raymond J. Hah, Ram K. Alluri
Format: Article
Language:English
Published: Korean Spinal Neurosurgery Society 2024-12-01
Series:Neurospine
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Online Access:http://e-neurospine.org/upload/pdf/ns-2448624-312.pdf
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author Jacob R. Ball
Matthew C. Gallo
Kareem Kebaish
Nicole Hang
Andy Ton
Fergui Hernandez
Marc Abdou
William J. Karakash
Jeffrey C. Wang
Raymond J. Hah
Ram K. Alluri
author_facet Jacob R. Ball
Matthew C. Gallo
Kareem Kebaish
Nicole Hang
Andy Ton
Fergui Hernandez
Marc Abdou
William J. Karakash
Jeffrey C. Wang
Raymond J. Hah
Ram K. Alluri
author_sort Jacob R. Ball
collection DOAJ
description Objective The purpose of this study is to describe utilization, demographics, complications, and revisions for patients with degenerative spondylolisthesis (DS) with stenosis undergoing decompression or decompression with fusion in the United States. Methods A national insurance database was used to identify patients who underwent either decompression and fusion or decompression alone for management of DS from 2010–2022. Utilization trends, demographics, and complications for each procedure were compared. Results A total of 162,878 patients were identified, of which 78,043 patients underwent combined single-level lumbar decompression and fusion and 84,835 underwent single-level lumbar decompression alone. Between 2010–2021, lumbar decompression and fusion became the predominant surgical intervention for DS in 2016 and continued to account for more than half of all procedures during the remainder of the study period. Factors such as age, sex, comorbidities, geographic region, and physician specialty training were associated with procedure choice. Decompression with fusion was associated with a lower risk of revision surgery up to 5 years postoperatively and an overall lower incidence of 30-day complications. Conclusion Decompression with fusion has become the most common treatment for lumbar DS over the past decade despite a lack of compelling evidence supporting its use compared to decompression alone. A variety of patient and surgeon-specific factors is associated with procedure choice. After accounting for cofounders, we identified treatment-specific complications that may be valuable when counseling patients.
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spelling doaj-art-9928a7e2a18e4bc2b0254f7b755135fe2025-08-20T01:55:03ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912024-12-012141068107710.14245/ns.2448624.3121632National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus DecompressionJacob R. Ball0Matthew C. Gallo1Kareem Kebaish2Nicole Hang3Andy Ton4Fergui Hernandez5Marc Abdou6William J. Karakash7Jeffrey C. Wang8Raymond J. Hah9Ram K. Alluri10 Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USAObjective The purpose of this study is to describe utilization, demographics, complications, and revisions for patients with degenerative spondylolisthesis (DS) with stenosis undergoing decompression or decompression with fusion in the United States. Methods A national insurance database was used to identify patients who underwent either decompression and fusion or decompression alone for management of DS from 2010–2022. Utilization trends, demographics, and complications for each procedure were compared. Results A total of 162,878 patients were identified, of which 78,043 patients underwent combined single-level lumbar decompression and fusion and 84,835 underwent single-level lumbar decompression alone. Between 2010–2021, lumbar decompression and fusion became the predominant surgical intervention for DS in 2016 and continued to account for more than half of all procedures during the remainder of the study period. Factors such as age, sex, comorbidities, geographic region, and physician specialty training were associated with procedure choice. Decompression with fusion was associated with a lower risk of revision surgery up to 5 years postoperatively and an overall lower incidence of 30-day complications. Conclusion Decompression with fusion has become the most common treatment for lumbar DS over the past decade despite a lack of compelling evidence supporting its use compared to decompression alone. A variety of patient and surgeon-specific factors is associated with procedure choice. After accounting for cofounders, we identified treatment-specific complications that may be valuable when counseling patients.http://e-neurospine.org/upload/pdf/ns-2448624-312.pdfdegenerative spondylolisthesislumbar spinefusiondecompression
spellingShingle Jacob R. Ball
Matthew C. Gallo
Kareem Kebaish
Nicole Hang
Andy Ton
Fergui Hernandez
Marc Abdou
William J. Karakash
Jeffrey C. Wang
Raymond J. Hah
Ram K. Alluri
National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression
Neurospine
degenerative spondylolisthesis
lumbar spine
fusion
decompression
title National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression
title_full National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression
title_fullStr National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression
title_full_unstemmed National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression
title_short National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression
title_sort national trends in lumbar degenerative spondylolisthesis with stenosis treated with fusion versus decompression
topic degenerative spondylolisthesis
lumbar spine
fusion
decompression
url http://e-neurospine.org/upload/pdf/ns-2448624-312.pdf
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