Abstract
Study Design: Analysis of a national database. Objective: To analyze trends in spinal fusion surgery for neurofibromatosis type I (NF-1) patients and to compare the surgical approaches. Summary of Background Data: The preferred surgical approach for fusion treatment of spinal deformity in NF is not well established. Methods: We identified 548 patients with a diagnosis of NF-1 who had received spinal fusion surgery between 2003 and 2014. We compared posterior spinal fusion (PSF), anterior-posterior spinal fusion (APSF), and anterior spinal fusion with respect to patient demographics, institutional characteristics, in-hospital complications, and hospitalization lengths and costs. Significance was set at a value of p less than.05. Results: The number of spinal fusions for NF-1 significantly increased (p =.02) over the study period. The rate of PSF surgeries increased 2.9-fold, whereas the rate of APSF surgeries decreased 2.2-fold. There was also a significant association between the location of the fusion and surgical approach (p<.01), with 66% of ASF cases being cervical spine cases. Compared with patients undergoing PSF and ASF, patients undergoing APSF were significantly younger (p<.01) and had significantly higher hospitalization lengths and costs (p<.01). APSF costs were $180,714 as compared to $144,027 for PSF and $105,312 for ASF. Conclusions: There have been significant increases in the rate of spinal fusion surgeries for NF-1 patients. Surgical treatment has shifted over the years and is dependent on the location of the deformity. Patients undergoing APSF are significantly younger. Level of Evidence: Level III.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 712-718 |
| Number of pages | 7 |
| Journal | Spine Deformity |
| Volume | 6 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 1 2018 |
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Keywords
- Complications
- Neurofibromatosis type I
- Scoliosis
- Spinal Fusion
- Trends
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
Cite this
National Trends in Spinal Fusion Surgery for Neurofibromatosis. / Kurucan, Etka; Bernstein, David N.; Thirukumaran, Caroline; Jain, Amit; Menga, Emmanuel Nganku; Rubery, Paul T.; Mesfin, Addisu.
In: Spine Deformity, Vol. 6, No. 6, 01.11.2018, p. 712-718.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - National Trends in Spinal Fusion Surgery for Neurofibromatosis
AU - Kurucan, Etka
AU - Bernstein, David N.
AU - Thirukumaran, Caroline
AU - Jain, Amit
AU - Menga, Emmanuel Nganku
AU - Rubery, Paul T.
AU - Mesfin, Addisu
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Study Design: Analysis of a national database. Objective: To analyze trends in spinal fusion surgery for neurofibromatosis type I (NF-1) patients and to compare the surgical approaches. Summary of Background Data: The preferred surgical approach for fusion treatment of spinal deformity in NF is not well established. Methods: We identified 548 patients with a diagnosis of NF-1 who had received spinal fusion surgery between 2003 and 2014. We compared posterior spinal fusion (PSF), anterior-posterior spinal fusion (APSF), and anterior spinal fusion with respect to patient demographics, institutional characteristics, in-hospital complications, and hospitalization lengths and costs. Significance was set at a value of p less than.05. Results: The number of spinal fusions for NF-1 significantly increased (p =.02) over the study period. The rate of PSF surgeries increased 2.9-fold, whereas the rate of APSF surgeries decreased 2.2-fold. There was also a significant association between the location of the fusion and surgical approach (p<.01), with 66% of ASF cases being cervical spine cases. Compared with patients undergoing PSF and ASF, patients undergoing APSF were significantly younger (p<.01) and had significantly higher hospitalization lengths and costs (p<.01). APSF costs were $180,714 as compared to $144,027 for PSF and $105,312 for ASF. Conclusions: There have been significant increases in the rate of spinal fusion surgeries for NF-1 patients. Surgical treatment has shifted over the years and is dependent on the location of the deformity. Patients undergoing APSF are significantly younger. Level of Evidence: Level III.
AB - Study Design: Analysis of a national database. Objective: To analyze trends in spinal fusion surgery for neurofibromatosis type I (NF-1) patients and to compare the surgical approaches. Summary of Background Data: The preferred surgical approach for fusion treatment of spinal deformity in NF is not well established. Methods: We identified 548 patients with a diagnosis of NF-1 who had received spinal fusion surgery between 2003 and 2014. We compared posterior spinal fusion (PSF), anterior-posterior spinal fusion (APSF), and anterior spinal fusion with respect to patient demographics, institutional characteristics, in-hospital complications, and hospitalization lengths and costs. Significance was set at a value of p less than.05. Results: The number of spinal fusions for NF-1 significantly increased (p =.02) over the study period. The rate of PSF surgeries increased 2.9-fold, whereas the rate of APSF surgeries decreased 2.2-fold. There was also a significant association between the location of the fusion and surgical approach (p<.01), with 66% of ASF cases being cervical spine cases. Compared with patients undergoing PSF and ASF, patients undergoing APSF were significantly younger (p<.01) and had significantly higher hospitalization lengths and costs (p<.01). APSF costs were $180,714 as compared to $144,027 for PSF and $105,312 for ASF. Conclusions: There have been significant increases in the rate of spinal fusion surgeries for NF-1 patients. Surgical treatment has shifted over the years and is dependent on the location of the deformity. Patients undergoing APSF are significantly younger. Level of Evidence: Level III.
KW - Complications
KW - Neurofibromatosis type I
KW - Scoliosis
KW - Spinal Fusion
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=85046734682&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046734682&partnerID=8YFLogxK
U2 - 10.1016/j.jspd.2018.03.012
DO - 10.1016/j.jspd.2018.03.012
M3 - Article
VL - 6
SP - 712
EP - 718
JO - Spine Deformity
JF - Spine Deformity
SN - 2212-134X
IS - 6
ER -