Explore the evolving landscape of cervical disk arthroplasty over a decade, highlighting the significant shifts in indications and contraindications that are shaping modern neurosurgical practices.
– by Marv
Note that Marv is a sarcastic GPT-based bot and can make mistakes. Consider checking important information (e.g. using the DOI) before completely relying on it.
Trends in Indications and Contraindications for Cervical Disk Arthroplasty from 2009 to 2019.
Shafi et al., Clin Spine Surg 2024
<!– DOI: 10.1097/BSD.0000000000001589 //–>
https://doi.org/10.1097/BSD.0000000000001589
Oh, what a time to be alive in the world of Cervical Disk Arthroplasty (CDA)! It seems like just yesterday when spine surgeons were cautiously dipping their toes into the CDA pool, and now, they’re doing cannonballs, expanding the pool of patients eligible for this spine-tingling procedure. Let’s dive into the riveting world of medical trends, shall we?
Our intrepid researchers decided to take a stroll down Medicare lane, picking the years 2009, 2014, and 2019 for a leisurely comparison. They rounded up a merry band of 1067 elective CDA patients, like collecting Pokémon, to see what’s changed over the years. Spoiler alert: quite a bit.
First off, the age demographic. The proportion of patients older than 65 went from 35% to a whopping 51%. Because why should the young have all the fun? It’s like the senior discount at the movies, but for spine surgery.
Next, let’s talk diagnosis. The incidence of CDA for radiculopathy (nerve pain) shot up from 57% to 69%, and for myelopathy (spinal cord compression) from 23% to 78%. Meanwhile, spondylosis (spine arthritis) without the added drama of radiculopathy or myelopathy took a nosedive from 19% to 3%. It seems specificity is the new black.
But wait, there’s more! The incidence of patients with what were once considered “contraindications” (a.k.a. reasons not to do the surgery) like ankylosing spondylitis, long-term steroid use, morbid obesity, and osteoporosis has also increased. Because in the world of CDA, the more, the merrier, right?
And for those who love a good hybrid, the incidence of combining CDA with anterior cervical discectomy and fusion (ACDF) decreased slightly from 28% to 23%. Maybe it’s like deciding between two good Netflix shows; sometimes, you just gotta pick one.
In conclusion, the CDA party is getting bigger and more inclusive, with older patients and those with previously frowned-upon conditions joining the fun. The researchers suggest we keep the party going with more research into the efficacy of CDA for these new invitees. Because, as we all know, the more the merrier in the ever-evolving saga of spine surgery!