{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:53Z","timestamp":1787755313025,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2017,9,20]]},"abstract":"\n Background:<\/jats:title>\n In order to identify any changes in the utilization of new and old techniques, we investigated trends in the operative management of cervical stenosis by orthopaedic surgeons applying for board certification.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We queried the American Board of Orthopaedic Surgery database from 1998 to 2013 to identify all of the cervical spine procedures for stenosis that had been performed by candidates taking Part II of the licensing examination. Longitudinal trends were determined for the utilized approach, the individual procedures that had been performed, and whether a motion-preserving technique had been employed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n There were 5,068 cervical spine procedures performed by 1,025 candidates. Procedure totals remained relatively constant until 2011, when a sudden increase of 280% (202 to 768 procedures) was noted. This trend continued, reaching a 460% increase (202 to 1,131 procedures) compared with 2010. The number of candidates only rose by 150% (42 to 105) over the entire study period. The proportion of procedures performed via an anterior approach saw a bimodal distribution; early on, this approach predominated over posterior procedures and was largely driven by the number of corpectomies that were performed. From 2004 to 2011, posterior procedures became more prevalent, but there was a sharp decline in 2011, driven by the large number of anterior cervical discectomies and fusions that were performed. This remained constant through 2013. Lastly, motion-preserving techniques, which included total disc replacement and laminoplasty, had modest increases in utilization from 2005 to 2007. This increased prevalence was short-lived, and it steadily declined through 2014 to <5% utilization.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The number of candidates performing cervical spine procedures increased more than twofold over a 16-year period. This reflects a larger proportion of the orthopaedic graduates who subspecialize in spine surgery. While the number of surgeons performing spine surgery has increased, the sheer number of procedures that each surgeon performed greatly outpaced the increased number of surgeons. Motion-preserving techniques had their peak utilization in 2007, and have since decreased to <5%, in contrast to fusion techniques, which predominate, comprising >90% of the performed procedures.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.16.01082","type":"journal-article","created":{"date-parts":[[2017,9,20]],"date-time":"2017-09-20T20:01:25Z","timestamp":1505937685000},"page":"e99","source":"Crossref","is-referenced-by-count":24,"title":["Trends in the Treatment of Single and Multilevel Cervical Stenosis"],"prefix":"10.2106","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3254-4550","authenticated-orcid":false,"given":"Alfredo","family":"Arrojas","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of South Carolina, Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9444-087X","authenticated-orcid":false,"given":"J. Benjamin","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of South Carolina, Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Grabowski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of South Carolina, Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"9","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1016\/j.spinee.2014.03.047","article-title":"Cervical arthroplasty: a critical review of the literature","volume":"14","author":"Alvin","year":"2014","journal-title":"Spine J."},{"key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/1749-799X-8-45","article-title":"Laminoplasty versus laminectomy for multi-level cervical spondylotic myelopathy: a systematic review of the literature","volume":"8","author":"Lao","year":"2013","journal-title":"J Orthop Surg Res."},{"issue":"6","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1097\/00007632-200003150-00004","article-title":"Outcome of patients treated for cervical myelopathy. 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An analysis of two hundred and eighty-eight patients with and without neurological deficits","volume":"76","author":"Kang","year":"1994","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"376","DOI":"10.2106\/JBJS.F.00437","article-title":"Prevalence of cervical spine stenosis. Anatomic study in cadavers","volume":"89","author":"Lee","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"9","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.2106\/00004623-199609000-00003","article-title":"The relationship of developmental narrowing of the cervical spinal canal to reversible and irreversible injury of the cervical spinal cord in football players","volume":"78","author":"Torg","year":"1996","journal-title":"J Bone Joint Surg Am."},{"issue":"12","key":"bib9-20230810","first-page":"1330","article-title":"Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy an independent matched cohort analysis","volume":"26","author":"Heller","year":"2001"},{"issue":"22","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1097\/BRS.0000000000000547","article-title":"Cervical degenerative disease: systematic review of economic analyses","volume":"39","author":"Alvin","year":"2014","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"546","DOI":"10.3171\/2013.8.SPINE12623","article-title":"Cost-effectiveness analysis: comparing single-level cervical disc replacement and single-level anterior cervical discectomy and fusion: clinical article","volume":"19","author":"Qureshi","year":"2013","journal-title":"J Neurosurg Spine."},{"issue":"1","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00586-014-3607-1","article-title":"Anterior cervical discectomy versus corpectomy for multilevel cervical spondylotic myelopathy: a meta-analysis","volume":"24","author":"Xiao","year":"2015","journal-title":"Eur Spine J."},{"issue":"6","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1007\/s11999-013-2830-0","article-title":"Is cervical disc arthroplasty superior to fusion for treatment of symptomatic cervical disc disease? A meta-analysis","volume":"471","author":"Yin","year":"2013","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"E17","DOI":"10.3171\/2010.1.FOCUS09305","article-title":"Management of unilateral cervical radiculopathy in the military: the cost effectiveness of posterior cervical foraminotomy compared with anterior cervical discectomy and fusion","volume":"28","author":"Tumial\u00e1n","year":"2010","journal-title":"Neurosurg Focus."},{"issue":"15","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1097\/BRS.0b013e3181bef3cb","article-title":"National trends in anterior cervical fusion procedures","volume":"35","author":"Marawar","year":"2010","journal-title":"Spine (Phila Pa 1976)."},{"issue":"2","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00701-007-1472-y","article-title":"Immediate (0-6 h), early (6-72 h) and late (>72 h) complications after anterior cervical discectomy with fusion for cervical disc degeneration; discharge six hours after operation is feasible","volume":"150","author":"Lied","year":"2008","journal-title":"Acta Neurochir (Wien)."},{"issue":"1","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00586-007-0518-4","article-title":"Surgical results of anterior corpectomy in the aged patients with cervical myelopathy","volume":"17","author":"Lu","year":"2008","journal-title":"Eur Spine J."},{"issue":"5","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.spinee.2005.01.011","article-title":"Anterior cervical decompression and fusion with plate fixation as an outpatient procedure","volume":"5","author":"Stieber","year":"2005","journal-title":"Spine J."},{"issue":"21","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1097\/BRS.0b013e318154c57e","article-title":"Anterior cervical discectomy and fusion associated complications","volume":"32","author":"Fountas","year":"2007","journal-title":"Spine (Phila Pa 1976)."},{"issue":"7","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/00007632-200004010-00007","article-title":"Health outcome assessment before and after anterior cervical discectomy and fusion for radiculopathy: a prospective analysis","volume":"25","author":"Klein","year":"2000","journal-title":"Spine (Phila Pa 1976)."},{"issue":"2","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/01376517-200504000-00007","article-title":"Health-related quality of life in patients undergoing anterior cervical discectomy fusion","volume":"37","author":"Fowler","year":"2005","journal-title":"J Neurosci Nurs."},{"issue":"19","key":"bib22-20230810","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1097\/01.brs.0000180479.63092.17","article-title":"Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study","volume":"30","author":"Yue","year":"2005","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"734","DOI":"10.3171\/2015.8.SPINE15219","article-title":"Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up","volume":"24","author":"Jackson","year":"2016","journal-title":"J Neurosurg Spine."},{"issue":"12","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1097\/01.BRS.0000065487.82469.D9","article-title":"Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy","volume":"28","author":"Suda","year":"2003","journal-title":"Spine (Phila Pa 1976)."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201709200-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:41:02Z","timestamp":1787751662000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201709200-00016"}},"subtitle":["A Review of the American Board of Orthopaedic Surgery Database"],"short-title":[],"issued":{"date-parts":[[2017,9,20]]},"references-count":24,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.16.01082","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,20]]}}}