June 24, 2013

162017_132140396847214_292624_nIn an article appearing in the June 1, 2013 edition of the journal Spine, researchers reported the results of a study of 212,385 cervical spine surgeries performed in the United States from 2002 to 2009. They found that 54.6% of the cervical spine surgeries were performed in teaching hospitals, where more multi-level fusions and posterior approaches (from the back of the neck) were performed. Teaching hospital cervical spine surgery patients tended to be male and were associated with increased costs and longer hospitalizations. Teaching hospitals also had increased surgery-related complications and an increased rate of mortality while in the hospital.

A “teaching hospital” is defined as a hospital that meets any of the following criteria: a hospital that has approval for residency training by the Accreditation Council for Graduate Medical Education (ACGME); a hospital that is a member in the Council of Teaching Hospitals; or, a hospital that has ratio of interns/residents to beds of 0.25 or greater. The researchers used data from the Nationwide Inpatient Sample (NIS) database, which is part of the Healthcare Cost and Utilization Project governed by the Agency for Healthcare Research and Quality.

NIS contains data from approximately 8 million hospital discharges each year from 45 U.S. states, representing approximately a 20% stratified sample of all discharges. Each entry in the NIS contains data from a single hospital admission on patient demographics, co-morbidities, diagnoses, surgical procedures, measurable outcomes such as length of hospitalization and cost, and hospital characteristics such as teaching status, size, and location.

The cervical spine surgeries studied were performed for cervical myelopathy and/or cervical radiculopathy. The cervical spine procedures were laminoforaminotomies, laminectomies, and laminoplasties, and were elective anterior or posterior cervical fusions or posterior cervical decompressions without fusion. The procedures were divided into one of two groups based on where they were performed: either at a teaching hospital or at a non-teaching hospital.

The researchers noted that their findings of longer hospitalizations, increased costs, higher post-operative complications, and higher mortality for cervical spine surgery patients in teaching hospitals may be due, in part, to the increased level of complexity of the cervical spine surgeries performed in teaching hospitals. The researchers also noted that an older age and co-morbidities were more significant predictors of mortality while in the hospital than whether the hospital was a teaching hospital or a non-teaching hospital. The study was limited to patients in the inpatient setting and did not research or report on long-term complications or long-term costs once the patients were discharged from the hospital (the researchers suggested that the post-inpatient experiences of cervical spine surgery patients should be the subject of future study).


If you or a loved one were injured during or after cervical spine surgery and your injuries may be due to medical negligence, you should promptly contact a local medical malpractice attorney in your state who may agree to investigate your possible medical malpractice claim for you and represent you in a medical malpractice lawsuit, if appropriate.

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