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. 2020 Sep:141:e175-e181.
doi: 10.1016/j.wneu.2020.05.055. Epub 2020 May 19.

Predicting Trends in Cervical Spinal Surgery in the United States from 2020 to 2040

Sean N Neifert  1 , Michael L Martini  1 , Frank Yuk  1 , Ian T McNeill  1 , John M Caridi  1 , Jeremy Steinberger  1 , Eric Karl Oermann  2
Affiliations

Predicting Trends in Cervical Spinal Surgery in the United States from 2020 to 2040

Sean N Neifert et al. World Neurosurg. 2020 Sep.

Abstract

Objective: We sought to predict surgical volumes for 2 common cervical spine procedures from 2020 to 2040.

Methods: Using the National Inpatient Sample from 2003-2016, nationwide estimates of anterior cervical diskectomy and fusion (ACDF) and posterior cervical decompression and fusion (PCDF) volumes were calculated using International Classification of Diseases, Ninth and Tenth Revision (ICD-9, ICD-10) procedure codes. With data from the U.S. Census Bureau, estimates of the U.S. population were used to create Poisson models controlling for age and sex. Age was categorized into ranges (<25 years old, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and >85), and estimates of surgical volume for each age group were created.

Results: From 2020-2040, increases in surgical volume from 13.3% (153,288-173,699) and 19.3% (29,620-35,335) are expected for ACDF and PCDF, respectively. For ACDF, the largest increases are expected in the 45-54 (42,077-49,827) and 75-84 (8065-14,862) age groups, whereas for PCDF, the largest increases will be seen in the 75-84 (3710-6836) age group. In accordance with an aging population, modest increases will be seen for ACDF (858-1847) and PCDF (730-1573) in the >85-year-old cohort.

Conclusions: As expected, large growth in cervical spine surgical volumes is likely to be seen, which could indicate a need for increased numbers of spinal neurosurgeons and orthopedic surgeons. Further studies are needed to investigate the needs of the field in light of these expected increases in volume.

Keywords: Aging population; Anterior cervical diskectomy and fusion; Posterior cervical decompression and fusion; Projections; Surgical volume; United States.

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