Trends in US Spinal Surgery: A 6 Year Analysis on Laminectomies. (16th November 2020)

• Record Type: Journal Article
• Authors: Singh, Rohin; Meyer, Benjamen; Patel, Naresh P; Pollock, Jordan
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_189
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: The spine has become a deeply contested area between neurosurgical and orthopedic spine specialists. Both specialties are trained to operate on a variety of spinal disorders, with a large degree of overlap in the cases they treat. While many studies have looked at patient outcomes for the two specialties, few have compared the number of procedures performed between the two. METHODS: Neurosurgical and Orthopedic Spine utilization data were obtained from the Medicare Provider Utilization Database from 2012 to 2017 on the Center for Medicare and Medicaid Services Website. All posterior approach laminectomy codes were selected which included: 63001, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63045, 63046, 63047, and 63048. The total number of services performed by neurosurgical and orthopedic specialties were summated for each year from 2012 to 2017. RESULTS: In 2012, 206, 874 total laminectomies were performed by neurosurgical and orthopedic spine specialists. Of these, 54.09% were performed by neurosurgeons, and 45.91% by orthopedic surgeons. In 2017, 218, 157 total laminectomies were performed by neurosurgical and orthopedic spine specialists. Of these, 51.17% were performed by neurosurgeons, and 48.82% by orthopedic surgeons. Overall, neurosurgeons were performing 8.18% more laminectomies than orthopedic surgeons in 2012, and this difference fell to just 2.35% in 2017. In this time period, orthopedic specialists increased the proportion of cervical and lumbar laminectomies they performed by 4.55% and 2.43% respectively, while neurosurgeons increased the proportion of thoracic laminectomies, they performed by 14.62%. CONCLUSION: The trends in this short six-year span demonstrate how orthopedic professionals are performing an increasing proportion of laminectomy procedures. While this has traditionally been in the domain of neurosurgery, this shift could represent a transformation in the training practices of these two specialties. Interestingly, neurosurgery saw a large jump in the number of thoracic laminectomies they performed, while orthopedics advanced more in the areas of cervical and lumbar laminectomies. This study warrants further investigation into the development of residency and fellowship training programs, and its effects on spinal practice.