Epidemiological trends in spine surgery over 10 years in a multicenter database

  • Kazuyoshi Kobayashi
  • Kei Ando
  • Yoshihiro Nishida
  • Naoki Ishiguro
  • Shiro Imagama
Original Article
  • 29 Downloads

Abstract

Purpose

There are few epidemiological studies of spinal surgery in Asia and none in Japan. The goal of this study was to review spine surgeries performed in our group between 2004 and 2015 in a cross-sectional study, with a focus on the effects of the superaging society on the characteristics and trends of spinal surgeries.

Methods

A retrospective review was performed for all 45,831 spinal surgeries conducted between 2004 and 2015 and recorded in our prospective multicenter database.

Results

During the study period, there was a significant increase in annual spine surgeries (p < 0.05). The proportion of elderly patients (aged ≥ 70) also increased, and the mean age at the time of surgery significantly increased from 54.6 years in 2004 to 63.7 years in 2015 (p < 0.05). Regarding the etiology, there were significant increases in degenerative disease (p < 0.01) and osteoporotic vertebral fracture, and a significant decrease in rheumatic spondylosis from 2004 to 2015 (p < 0.01). Instrumentation surgery increased over time, with the performance of MIS, BKP and LLIF as new procedures in recent years (p < 0.01). The mean reoperation rate was 2.0% and this rate did not change significantly over time, although the rate of reoperation due to surgical site infection significantly increased from 0.9 to 1.5% (p < 0.05).

Conclusions

Our data showed marked increases in the number of spine surgeries, the age of patients, and the number of surgeries for degenerative diseases. This large-scale study provides indicators for planning the future development of spine surgery and for treatment of spinal diseases in daily practice.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Spine surgery Epidemiology Elderly Surgical approaches Complications Superaging 

Notes

Acknowledgments

We are grateful to all the staff of Nagoya Spine Group for allowing us to study their patients.

Compliance with ethical standards

Conflict of interest

None of the authors have a conflict of interest.

References

  1. 1.
  2. 2.
    Statistics Bureau (2015) The 64th Japan statistical yearbook 49Google Scholar
  3. 3.
    Kobayashi K, Imagama S, Sato K et al (2018) Postoperative complications associated with spine surgery in patients over 90 years old: a multicenter retrospective study. Global Spine J (in press) Google Scholar
  4. 4.
    Kobayashi K, Imagama S, Ando K et al (2017) Complications associated with spine surgery in patients aged 80 years or older: Japan Association of Spine Surgeons with Ambition (JASA) multicenter study. Global Spine J 7:636–641CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Kobayashi K, Imagama S, Ando K et al (2017) Risk factors for delirium after spine surgery in extremely elderly patients aged 80 years or older and review of the literature: Japan Association of Spine Surgeons with Ambition (JASA) multicenter study. Global Spine J 7:560–566CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Schwab F, Ungar B, Blondel B et al (2012) Scoliosis research society-Schwab adult spinal deformity classification. Spine 37:1077–1082CrossRefPubMedGoogle Scholar
  7. 7.
    Cortesi PA, Assietti R, Cuzzocrea F et al (2017) Epidemiologic and economic burden attributable to first spinal fusion surgery: analysis from an Italian administrative database. Spine 15:1398–1404CrossRefGoogle Scholar
  8. 8.
    Oglesby M, Fineberg SJ, Patel AA et al (2013) Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009. Spine 38:1226–1232CrossRefPubMedGoogle Scholar
  9. 9.
    Marquez-Lara A, Nandyala SV, Fineberg SJ et al (2014) Current trends in demographics, practice, and in-hospital outcomes in cervical spine surgery: a national database analysis between 2002 and 2011. Spine 39:476–481CrossRefPubMedGoogle Scholar
  10. 10.
    Thirukumaran CP, Raudenbush B, Li Y et al (2016) National trends in the surgical management of adult lumbar isthmic spondylolisthesis: 1998 to 2011. Spine 41:490–501CrossRefPubMedGoogle Scholar
  11. 11.
    Kim P, Kurokawa R, Itoki K (2010) Technical advancements and utilization of spine surgery: international disparities in trend-dynamics between Japan, Korea, and the USA. Neurol Med Chir 50:853–858CrossRefGoogle Scholar
  12. 12.
    Imajo Y, Taguchi T, Yone K et al (2015) Japanese 2011 nationwide survey on complications from spine surgery. J Orthop Sci 20:38–54CrossRefPubMedGoogle Scholar
  13. 13.
    Liu Y, Liu Z, Zhu F et al (2013) Validation and reliability analysis of the new SRS-Schwab classification for adult spinal deformity. Spine 38:902–908CrossRefPubMedGoogle Scholar
  14. 14.
    Maini RN, Breedveld FC, Kalden JR et al (2004) Sustained improvement over two years in physical function, structural damage, and signs and symptoms among patients with rheumatoid arthritis treated with infliximab and methotrexate. Arthritis Rheum 50:1051–1065CrossRefPubMedGoogle Scholar
  15. 15.
    Kaito T, Ohshima S, Fujiwara H et al (2013) Predictors for the progression of cervical lesion in rheumatoid arthritis under the treatment of biological agents. Spine 38:2258–2263CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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