Trends in cervical laminoplasty: Medicare projections through 2060.

Context: Cervical laminoplasty is a motion-preserving surgical alternative to laminectomy and fusion for multilevel cervical myelopathy. While studies have explored its clinical outcomes, few have assessed national trends or projected future procedural volumes, particularly within the aging Medicare population.

Aims: The aim of this study is to analyze historical trends in cervical laminoplasty utilization within the Medicare population and project future procedural volumes through 2060.

Settings and design: Retrospective trend analysis using a national database.

Subjects and methods: A retrospective analysis was conducted using the Centers for Medicare and Medicaid Services Medicare Part B National Summary database from 2005 to 2022. Laminoplasty procedures were identified using current procedural terminology codes 63050 and 63051. To account for increasing Medicare Advantage enrollment, a correction factor was applied based on Kaiser Family Foundation data.

Statistical analysis used: Four forecasting models - log-linear, Poisson, negative binomial regression, and auto-regressive integrated moving average - were evaluated to project future utilization. Model performance was assessed using mean absolute error and root mean square error. The Poisson regression model was selected for its balance of predictive accuracy and reliability.

Results: From 2005 to 2022, laminoplasty volume increased 200.7%, from 811 to 2,437 procedures annually. The Poisson model projected an average 5.1% annual growth rate, with procedural volume reaching 15,528 by 2060 (95% confidence interval: 13,992-17,234), representing a 537% increase from 2022 levels.

Conclusions: Cervical laminoplasty utilization is projected to increase considerably through 2060. As demand rises, further studies should explore factors influencing growth and assess broader implications for surgical decision-making and policy.