A study presented at the Cervical Spine Research Society annual meeting in 2015 examined trends in cervical spinal fusion over the past 16 years.
The study authors examined the New York Statewide Planning and Research Cooperative System for patients who underwent cervical fusions from 1997 to 2012 and collected data on patient demographics as well as whether bone morphogenetic protein was used. There were 87,106 cervical fusions included in the study, primarily anterior — 85.2 percent — and posterior — 12.3 percent. The remaining 2.5 percent of fusions were circumferential.
The study authors found:
1. Surgeons used BMP in 4.3 percent of the cases from 2002 to 2012.
2. Anterior approach utilization increased 107 percent from 1997 to 2012 for patients 36 years old and older. The posterior fusion rate increased 270 percent for patients 36 years old and older.
3. The most common indications for anterior cervical fusion were:
• Degenerative disc disease
• Spondylolisthesis
• Spinal stenosis
• Fracture
4. The anterior cervical fusion diagnosis for degenerative disc disease increased 83 percent over the study period; for spondylolisthesis the diagnosis increased 162 percent; for spinal stenosis the diagnosis increased 208 percent; for fracture, the diagnosis increased 57 percent.
5. The indications for posterior cervical fusion were similar; degenerative disc disease increased 164 percent over the study period while spondylolisthesis increased 625 percent, spinal stenosis increased 439 percent and fracture increased 135 percent.
6. The use of BMP in anterior cervical fusions peaked in 2009, when the usage rate was 59 cases per 1,000 cases. Among posterior cervical fusions, BMP use was 125 of every 1,000 cases in 2008 when it reached maximum utilization.