Interspinous device versus laminectomy for lumbar spinal stenosis: A comparative effectiveness study

Chirag G. Patil, J. Manuel Sarmiento, Beatrice Ugiliweneza, Debraj Mukherjee, Miriam Nuño, John C. Liu, Sartaaj Walia, Shivanand P. Lad, Maxwell Boakye

Research output: Contribution to journalArticle

Abstract

Background context Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients. Purpose To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy. Study design Retrospective comparative study. Patient sample The MarketScan database (2007-2009) was queried for adults with LSS undergoing ID placement as a primary inpatient procedure. Outcome measures Reoperation rates, complication rates, and costs. Methods Each ID patient was matched with a laminectomy patient using propensity score matching. Reoperations, complications, and costs were analyzed in patients with at least 18 months postoperative follow-up. The authors did not receive funding from any external sources for this study. Results Among 498 inpatients that underwent ID placement between 2007 and 2009; the average age was 73 years. The cumulative reoperation rates after ID at 12 and 18 months were 21% and 23%, respectively. The average inpatient hospitalization lasted 1.6 days with an associated cost of $17,432. Two propensity-matched cohorts of 174 patients that had undergone ID versus laminectomy were analyzed. Longer length of stay was observed in the laminectomy cohort (2.5 days vs. 1.6 days, p<.0001), whereas ID patients accrued higher costs at index hospitalization ($17,674 vs. $12,670, p=.0001). Index hospitalization (7.5% vs. 3.5%, p=.099) and 90-day (9.2% vs. 3.5%, p=.028) complications were higher in the laminectomy cohort compared with the ID cohort. The ID patients had significantly higher reoperation rates than laminectomy patients at 12 months follow-up (12.6% vs. 5.8%, p=.026) and incurred higher cumulative costs than laminectomy patients at 12 months follow-up ($39,173 vs. $34,324, p=.289). Conclusions Twelve-month reoperation rates and index hospitalization costs were significantly higher among patients who underwent ID compared with laminectomy for LSS.

Original languageEnglish (US)
Pages (from-to)1484-1492
Number of pages9
JournalSpine Journal
Volume14
Issue number8
DOIs
StatePublished - Aug 1 2014
Externally publishedYes

Fingerprint

Spinal Stenosis
Laminectomy
Equipment and Supplies
Reoperation
Costs and Cost Analysis
Hospitalization
Inpatients
Propensity Score
Length of Stay
Retrospective Studies

Keywords

  • Decompressive surgery
  • Interspinous device
  • Laminectomy
  • Lumbar spinal stenosis
  • Neurogenic claudication
  • Reoperation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Patil, C. G., Sarmiento, J. M., Ugiliweneza, B., Mukherjee, D., Nuño, M., Liu, J. C., ... Boakye, M. (2014). Interspinous device versus laminectomy for lumbar spinal stenosis: A comparative effectiveness study. Spine Journal, 14(8), 1484-1492. https://doi.org/10.1016/j.spinee.2013.08.053

Interspinous device versus laminectomy for lumbar spinal stenosis : A comparative effectiveness study. / Patil, Chirag G.; Sarmiento, J. Manuel; Ugiliweneza, Beatrice; Mukherjee, Debraj; Nuño, Miriam; Liu, John C.; Walia, Sartaaj; Lad, Shivanand P.; Boakye, Maxwell.

In: Spine Journal, Vol. 14, No. 8, 01.08.2014, p. 1484-1492.

Research output: Contribution to journalArticle

Patil, CG, Sarmiento, JM, Ugiliweneza, B, Mukherjee, D, Nuño, M, Liu, JC, Walia, S, Lad, SP & Boakye, M 2014, 'Interspinous device versus laminectomy for lumbar spinal stenosis: A comparative effectiveness study', Spine Journal, vol. 14, no. 8, pp. 1484-1492. https://doi.org/10.1016/j.spinee.2013.08.053
Patil, Chirag G. ; Sarmiento, J. Manuel ; Ugiliweneza, Beatrice ; Mukherjee, Debraj ; Nuño, Miriam ; Liu, John C. ; Walia, Sartaaj ; Lad, Shivanand P. ; Boakye, Maxwell. / Interspinous device versus laminectomy for lumbar spinal stenosis : A comparative effectiveness study. In: Spine Journal. 2014 ; Vol. 14, No. 8. pp. 1484-1492.
@article{de40f8ec7c6b49268786bc3b90b0f2af,
title = "Interspinous device versus laminectomy for lumbar spinal stenosis: A comparative effectiveness study",
abstract = "Background context Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients. Purpose To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy. Study design Retrospective comparative study. Patient sample The MarketScan database (2007-2009) was queried for adults with LSS undergoing ID placement as a primary inpatient procedure. Outcome measures Reoperation rates, complication rates, and costs. Methods Each ID patient was matched with a laminectomy patient using propensity score matching. Reoperations, complications, and costs were analyzed in patients with at least 18 months postoperative follow-up. The authors did not receive funding from any external sources for this study. Results Among 498 inpatients that underwent ID placement between 2007 and 2009; the average age was 73 years. The cumulative reoperation rates after ID at 12 and 18 months were 21{\%} and 23{\%}, respectively. The average inpatient hospitalization lasted 1.6 days with an associated cost of $17,432. Two propensity-matched cohorts of 174 patients that had undergone ID versus laminectomy were analyzed. Longer length of stay was observed in the laminectomy cohort (2.5 days vs. 1.6 days, p<.0001), whereas ID patients accrued higher costs at index hospitalization ($17,674 vs. $12,670, p=.0001). Index hospitalization (7.5{\%} vs. 3.5{\%}, p=.099) and 90-day (9.2{\%} vs. 3.5{\%}, p=.028) complications were higher in the laminectomy cohort compared with the ID cohort. The ID patients had significantly higher reoperation rates than laminectomy patients at 12 months follow-up (12.6{\%} vs. 5.8{\%}, p=.026) and incurred higher cumulative costs than laminectomy patients at 12 months follow-up ($39,173 vs. $34,324, p=.289). Conclusions Twelve-month reoperation rates and index hospitalization costs were significantly higher among patients who underwent ID compared with laminectomy for LSS.",
keywords = "Decompressive surgery, Interspinous device, Laminectomy, Lumbar spinal stenosis, Neurogenic claudication, Reoperation",
author = "Patil, {Chirag G.} and Sarmiento, {J. Manuel} and Beatrice Ugiliweneza and Debraj Mukherjee and Miriam Nu{\~n}o and Liu, {John C.} and Sartaaj Walia and Lad, {Shivanand P.} and Maxwell Boakye",
year = "2014",
month = "8",
day = "1",
doi = "10.1016/j.spinee.2013.08.053",
language = "English (US)",
volume = "14",
pages = "1484--1492",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "8",

}

TY - JOUR

T1 - Interspinous device versus laminectomy for lumbar spinal stenosis

T2 - A comparative effectiveness study

AU - Patil, Chirag G.

AU - Sarmiento, J. Manuel

AU - Ugiliweneza, Beatrice

AU - Mukherjee, Debraj

AU - Nuño, Miriam

AU - Liu, John C.

AU - Walia, Sartaaj

AU - Lad, Shivanand P.

AU - Boakye, Maxwell

PY - 2014/8/1

Y1 - 2014/8/1

N2 - Background context Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients. Purpose To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy. Study design Retrospective comparative study. Patient sample The MarketScan database (2007-2009) was queried for adults with LSS undergoing ID placement as a primary inpatient procedure. Outcome measures Reoperation rates, complication rates, and costs. Methods Each ID patient was matched with a laminectomy patient using propensity score matching. Reoperations, complications, and costs were analyzed in patients with at least 18 months postoperative follow-up. The authors did not receive funding from any external sources for this study. Results Among 498 inpatients that underwent ID placement between 2007 and 2009; the average age was 73 years. The cumulative reoperation rates after ID at 12 and 18 months were 21% and 23%, respectively. The average inpatient hospitalization lasted 1.6 days with an associated cost of $17,432. Two propensity-matched cohorts of 174 patients that had undergone ID versus laminectomy were analyzed. Longer length of stay was observed in the laminectomy cohort (2.5 days vs. 1.6 days, p<.0001), whereas ID patients accrued higher costs at index hospitalization ($17,674 vs. $12,670, p=.0001). Index hospitalization (7.5% vs. 3.5%, p=.099) and 90-day (9.2% vs. 3.5%, p=.028) complications were higher in the laminectomy cohort compared with the ID cohort. The ID patients had significantly higher reoperation rates than laminectomy patients at 12 months follow-up (12.6% vs. 5.8%, p=.026) and incurred higher cumulative costs than laminectomy patients at 12 months follow-up ($39,173 vs. $34,324, p=.289). Conclusions Twelve-month reoperation rates and index hospitalization costs were significantly higher among patients who underwent ID compared with laminectomy for LSS.

AB - Background context Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients. Purpose To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy. Study design Retrospective comparative study. Patient sample The MarketScan database (2007-2009) was queried for adults with LSS undergoing ID placement as a primary inpatient procedure. Outcome measures Reoperation rates, complication rates, and costs. Methods Each ID patient was matched with a laminectomy patient using propensity score matching. Reoperations, complications, and costs were analyzed in patients with at least 18 months postoperative follow-up. The authors did not receive funding from any external sources for this study. Results Among 498 inpatients that underwent ID placement between 2007 and 2009; the average age was 73 years. The cumulative reoperation rates after ID at 12 and 18 months were 21% and 23%, respectively. The average inpatient hospitalization lasted 1.6 days with an associated cost of $17,432. Two propensity-matched cohorts of 174 patients that had undergone ID versus laminectomy were analyzed. Longer length of stay was observed in the laminectomy cohort (2.5 days vs. 1.6 days, p<.0001), whereas ID patients accrued higher costs at index hospitalization ($17,674 vs. $12,670, p=.0001). Index hospitalization (7.5% vs. 3.5%, p=.099) and 90-day (9.2% vs. 3.5%, p=.028) complications were higher in the laminectomy cohort compared with the ID cohort. The ID patients had significantly higher reoperation rates than laminectomy patients at 12 months follow-up (12.6% vs. 5.8%, p=.026) and incurred higher cumulative costs than laminectomy patients at 12 months follow-up ($39,173 vs. $34,324, p=.289). Conclusions Twelve-month reoperation rates and index hospitalization costs were significantly higher among patients who underwent ID compared with laminectomy for LSS.

KW - Decompressive surgery

KW - Interspinous device

KW - Laminectomy

KW - Lumbar spinal stenosis

KW - Neurogenic claudication

KW - Reoperation

UR - http://www.scopus.com/inward/record.url?scp=84905497966&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905497966&partnerID=8YFLogxK

U2 - 10.1016/j.spinee.2013.08.053

DO - 10.1016/j.spinee.2013.08.053

M3 - Article

C2 - 24291409

AN - SCOPUS:84905497966

VL - 14

SP - 1484

EP - 1492

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

IS - 8

ER -