National and regional rates and variation of cervical discectomy with and without anterior fusion, 1990-1999

Study Design. A national hospitalization database was used to determine rates and trends in the treatment of cervical disc disease. Objective. To examine the temporal and geographic variations in hospitalizations and surgical procedures for cervical disc disease. Summary of Background Data. Studies of spinal surgery during the 1980s showed significant increases in the rates for all procedures, particularly those involving fusion. The management of cervical disc disease continues to be controversial. Methods. Data from the National Hospital Discharge Survey from 1990 through 1999 were analyzed. Records were selected and categorized according to an algorithm of International Classification of Diseases (ICD-9) procedure and diagnosis codes. Results. During the study period, the rate of hospitalization for surgical and nonsurgical treatment of cervical disc disease did not increase significantly. There was, however, a statistically significant increase in the proportion of hospitalizations for the surgical treatment of cervical disc disease that included a fusion procedure. There also was significant geographic variation in the rate of fusion procedures, with the South having the highest rate. Conclusions. Although the rate of surgery for cervical disc disease did not increase significantly during the 1990s, the rate of fusion procedures did rise significantly.