Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P114. Trend of the use of laminoplasty to treat cervical stenosis in the United States

Abstract

BACKGROUND CONTEXT Laminoplasty is used for posterior decompression of the spinal cord. Numerous studies demonstrate its comparable effectiveness with other operative strategies for a number of different clinical outcomes. Given the results of these studies, and the increased literary discussion of this procedure to manage cervical stenosis, we investigated the trend in using laminoplasty compared with other operative procedures in the management of cervical stenosis. PURPOSE Determine the current United States’ trend of using laminoplasty compared with other surgical management strategies for cervical stenosis. STUDY DESIGN/SETTING Retrospective cohort study of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database of patients who underwent surgery for cervical stenosis from 2007 to 2015. PATIENT SAMPLE All patients who had a diagnosis of cervical stenosis from 2007 to 2015 were identified in the ACS-NSQUIP database. Current Procedural Terminology codes were extracted for each case. OUTCOME MEASURES Number of patients who underwent anterior cervical discectomy and fusion (ACDF); anterior corpectomy; cervical arthroplasty; posterior laminectomy; posterior discectomy; posterior laminectomy and fusion; and laminoplasty. METHODS We identified in the ACS-NSQIP database patients with a diagnosis of cervical stenosis who underwent a surgery for that condition. Patients were grouped yearly by the type of surgery they underwent. Longitudinal trends were identified with a linear regression model and year-to-year data was compared with a z-test for population proportions. RESULTS A total of 37,843 patients underwent surgery for cervical stenosis from 2007 to 2015. ACDF was the most commonly-performed surgery, accounting for approximately 70% of the surgeries performed yearly. Accounting for increases in the number of total surgeries per year seen in the NSQIP data base, no group demonstrated a significant increase or decrease per year or across the seven years. Additionally, not one group increased or decreased by greater than 1% per year. CONCLUSIONS Over the past fifteen to twenty years, numerous studies have demonstrated that laminoplasty is an equivalent or superior form of treating cervical stenosis compared with posterior cervical fusion and anterior discectomy and fusion in select patients. Despite these findings, this study demonstrates that using laminoplasty to treat cervical stenosis has not significantly increased in the United States from 2007 to 2015. In fact, the proportion of surgeries used to treat cervical stenosis has not significantly changed since 2007.