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ORIGINAL CONTRIBUTION Trends, Major Medical Complications, and Charges Associated With Surgery for Lumbar Spinal Stenosis in Older Adults Richard A. Deyo, MD, MPH Context In recent decades, the fastest growth in lumbar surgery occurred in older Sohail K. Mirza, MD, MPH patients with spinal stenosis. Trials indicate that for selected patients, decompressive surgery offers an advantage over nonoperative treatment, but surgeons often recom- Brook I. Martin, MPH mend more invasive fusion procedures. Comorbidity is common in older patients, so William Kreuter, MPA benefits and risks must be carefully weighed in the choice of surgical procedure. David C. Goodman, MD, MS Objective To examine trends in use of different types of stenosis operations and the association of complications and resource use with surgical complexity. Jeffrey G. Jarvik, MD, MPH Design, Setting, and Patients Retrospective cohort analysis of Medicare claims N PLANNING SPINE OPERATIONS, SUR- for 2002-2007, focusing on 2007 to assess complications and resource use in US hos- geons have wide discretion. For pitals. Operations for Medicare recipients undergoing surgery for lumbar stenosis pain-related surgery, consensus on (n=32 152 in the first 11 months of 2007) were grouped into 3 gradations of inva- Iindications for specific proce- siveness: decompression alone,
JAMA – American Medical Association
Published: Apr 7, 2010
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