Cited by 1,041Spine and Intervertebral Disc PathologyMusculoskeletal pain and rehabilitationCervical and Thoracic Myelopathy

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Spinal Fusion in the United States: Analysis of Trends From 1998 to 2008

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Rajaee, Sean S., Bae, Hyun W., Kanim, Linda E.A., Delamarter, Rick B.·2012·Spine

DOI 10.1097/brs.0b013e31820cccfb

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Abstract

STUDY DESIGN: Epidemiological study using national administrative data. OBJECTIVE: To provide a complete analysis of national trends in spinal fusion from 1998 to 2008 and compare with trends in laminectomy, hip replacement, knee arthroplasty, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft. SUMMARY OF BACKGROUND DATA: Previous studies have reported a rapid increase in volume of spinal fusions in the United States prior to 2001, but limited reports exist beyond this point, analyzing all spinal fusion procedures collectively. METHODS: Data were obtained from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample for the years 1998 to 2008. Discharges were identified using International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes for the following procedures: spinal fusion, laminectomy, hip replacement, knee arthroplasty, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft. Population-based utilization rates were calculated from the US census data. RESULTS: Between 1998 and 2008, the annual number of spinal fusion discharges increased 2.4-fold (137%) from 174,223 to 413,171 (P < 0.001). In contrast, during the same time period, laminectomy, hip replacement, knee arthroplasty, and percutaneous coronary angioplasty yielded relative increases of only 11.3%, 49.1%, 126.8%, and 38.8% in discharges, while coronary artery bypass graft experienced a decrease of 40.1%. Between 1998 and 2008, mean age for spinal fusion increased from 48.8 to 54.2 years (P < 0.001), in-hospital mortality rate decreased from 0.29% to 0.25% (P < 0.01), and mean total hospital charges associated with spinal fusion increased 3.3-fold (P < 0.001). The national bill for spinal fusion increased 7.9-fold (P < 0.001). CONCLUSION: Frequency, utilization, and hospital charges of spinal fusion have increased at a higher rate than other notable inpatient procedures, as seen in this study from 1998 to 2008. In addition, patient demographics and hospital characteristics changed significantly; in particular, whereas the average age for spinal fusion increased, the in-hospital mortality rate decreased.

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Authors: Rajaee, S. S., Bae, H. W., Kanim, L. E. A., & Delamarter, R. B.
Affiliations: Tufts University (US)
Cedars-Sinai Medical Center (US)
Corresponding author: Rajaee, Sean S.
Bae, Hyun W.
Kanim, Linda E.A.
Delamarter, Rick B.
ORCID: Rajaee, Sean S.
Bae, Hyun W.
Kanim, Linda E.A.
Delamarter, Rick B.
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2012-01
Volume: 37
Issue: 1
Pages: 67-76
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/brs.0b013e31820cccfb
OpenAlex: W1994568570
Cited by: 1,041
References: 15
Citations by year: 2026: 46 · 2025: 43 · 2024: 70 · 2023: 64 · 2022: 85 · 2021: 96 · 2020: 94 · 2019: 88 · 2018: 118 · 2017: 88 · 2016: 66 · 2015: 72 · 2014: 52 · 2013: 34 · 2012: 17
FWCI: 24.68
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
Locations: Spine (publishedVersion, cc-by)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Surgery › Cervical and Thoracic Myelopathy
Keywords: spinal fusion, surgical utilization trends, laminectomy, total hip arthroplasty, knee arthroplasty, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, hospital charges, in-hospital mortality, patient age, hospital characteristics, health care costs, National Inpatient Sample, administrative claims data
MeSH terms: Adolescent, Adult, Aged, Coronary Artery Bypass, Child, Child, Preschool, Female, Humans, Infant, Laminectomy, Length of Stay, Male, Middle Aged, Spinal Diseases, Spinal Fusion, United States, Angioplasty, Balloon, Coronary, Survival Rate, Hospital Mortality, Arthroplasty, Replacement, Young Adult

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Spinal Fusion in the United States: Analysis of Trends From 1998 to 2008

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