Adoption of Endoscopic Spine Surgery: A 6-Year National Utilization Analysis.

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY
Rohan Vemu, Mohammed S Abdullah, Sachin Gupta, David Casper, Amrit Khalsa, Bijan Dehghani
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引用次数: 0

Abstract

Study design: Descriptive study.

Objective: To determine national trends in utilization of endoscopic spine surgery from 2017 to 2022.

Summary of background data: Endoscopic spine surgery (ESS) has emerged as a potential, minimally invasive approach to treat certain symptomatic spinal pathology. The benefits of ESS have not been well established; however, small case series suggest possible improvement in postoperative complications rates, decreased length of stay, and improved outcomes in comparison to traditional techniques. Despite this, adoption of ESS is not widespread in the United States.

Methods: Patients undergoing ESS were identified using the CPT code 62380 in the PearlDiver M165Ortho database from 2017 to 2022. Demographic factors extracted included: (1) age, (2) sex, (3) Elixhauser comorbidity index (ECI), (4) Charlson comorbidity index (CCI), (5) geographic region of surgery, (6) type of insurance plan (Commercial, Medicaid, Medicare), and (7) timing of the surgery.

Results: A total of 1886 patients who have undergone ESS were identified from 2017 to 2022. The utilization of ESS peaked in 2018 but reached a plateau after. The largest proportion of patients receiving ESS were over the age of 70 (30%) with 51% female (n=968). In addition, the majority of ESS were performed in the South (47.8%), and most payers utilized commercial health insurance (70.9%). Comorbidity indices for ESS patients were tracked: mean ECI +/- SD: 5.04+/-3.68; median ECI: 4 and mean CCI: 2.06; median CCI: 2.

Conclusions: The limited widespread adoption of ESS can be multifactorial. As with all new technologies, there is hesitation for early adoption, additionally the lack of standardized surgeon education, limited scope of procedure, and need for advanced surgical tools serve as possible reasons contributing to the trends in usage.

采用内窥镜脊柱手术:6年全国应用分析。
研究设计:描述性研究。目的:了解2017 - 2022年全国脊柱内窥镜手术应用趋势。背景资料总结:内窥镜脊柱手术(ESS)已成为治疗某些症状性脊柱病理的一种潜在的微创方法。ESS的好处还没有得到很好的证实;然而,与传统技术相比,小病例系列表明可能改善术后并发症发生率,缩短住院时间和改善预后。尽管如此,ESS的采用在美国并不普遍。方法:2017年至2022年,在PearlDiver M165Ortho数据库中使用CPT代码62380识别接受ESS治疗的患者。提取的人口学因素包括:(1)年龄,(2)性别,(3)Elixhauser合并症指数(ECI), (4) Charlson合并症指数(CCI),(5)手术的地理区域,(6)保险计划类型(商业、医疗补助、医疗保险),(7)手术时间。结果:2017 - 2022年共发现1886例ESS患者。ESS的利用率在2018年达到顶峰,但之后进入平稳期。接受ESS的患者中,70岁以上的患者占比最大(30%),其中女性占51% (n=968)。此外,大多数ESS在南方进行(47.8%),大多数支付者使用商业健康保险(70.9%)。追踪ESS患者的合并症指标:平均ECI +/- SD: 5.04+/-3.68;中位ECI: 4,平均CCI: 2.06;中位CCI: 2。结论:ESS有限的广泛应用可能是多因素的。与所有新技术一样,早期采用存在犹豫,此外,缺乏标准化的外科医生教育,手术范围有限以及对先进手术工具的需求可能是导致使用趋势的原因。
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来源期刊
Clinical Spine Surgery
Clinical Spine Surgery Medicine-Surgery
CiteScore
3.00
自引率
5.30%
发文量
236
期刊介绍: Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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