Interbody fusion rapidly adopted for spondylolisthesis

(HealthDay)—Interbody fusion (IF) has been rapidly adopted for the treatment of degenerative spondylolisthesis (DS), according to a study published in the Sept. 1 issue of Spine.

Christopher K. Kepler, M.D., M.B.A., from Thomas Jefferson University in Philadelphia, and colleagues used the American Board of Orthopaedic Surgery database to describe trends for patients who underwent surgery for DS from 1999 to 2011. Patients undergoing uninstrumented fusion, fusion with posterior instrumentation, fusion using interbody device, or decompression without fusion were included.

The researchers found that the annual number of cases doubled over the study period, with a total of 5,639 cases. Throughout the study period there was a significant increase in the percentage of cases treated with IF (13.6 percent in 1999 to 2001 versus 32 percent in 2009 to 2011; P < 0.001). In 2003, the percentage of DS cases treated with posterolateral fusion peaked followed by a decrease concomitant with the increasing rate of IF. The rates of posterolateral fusion and posterolateral fusion with IF were 40 and 37 percent, respectively, in 2011. The highest rate of IF was seen in the Northwest (41 percent), more than 10 and 23 percent higher than any other region and than the Southeast, respectively (both P < 0.001).

"Despite little evidence guiding treatment strategy for DS, national treatment patterns have changed dramatically during the past 13 years," conclude the authors.
Relevant financial activities outside the submitted work were disclosed.

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