{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:25:19Z","timestamp":1794324319821,"version":"4.9.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,6]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors performed a population-based analysis of national trends, costs, and outcomes associated with cervical spondylotic myelopathy (CSM) in the United States. They assessed postoperative complications, resource utilization, and predictors of costs, in this surgically treated CSM population.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n MarketScan data (2006\u20132010) were used to retrospectively analyze the complications and costs of different spine surgeries for CSM. The authors determined outcomes following anterior cervical discectomy and fusion (ACDF), posterior fusion, combined anterior\/posterior fusion, and laminoplasty procedures.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The authors identified 35,962 CSM patients, comprising 5154 elderly (age \u2265 65 years) patients (mean 72.2 years, 54.9% male) and 30,808 nonelderly patients (mean 51.1 years, 49.3% male). They found an overall complication rate of 15.6% after ACDF, 29.2% after posterior fusion, 41.1% after combined anterior and posterior fusion, and 22.4% after laminoplasty. Following ACDF and posterior fusion, a significantly higher risk of complication was seen in the elderly compared with the nonelderly (reference group). The fusion level and comorbidity-adjusted ORs with 95% CIs for these groups were 1.54 (1.40\u20131.68) and 1.25 (1.06\u20131.46), respectively. In contrast, the elderly population had lower 30-day readmission rates in all 4 surgical cohorts (ACDF, 2.6%; posterior fusion, 5.3%; anterior\/posterior fusion, 3.4%; and laminoplasty, 3.6%). The fusion level and comorbidity-adjusted odds ratios for 30-day readmissions for ACDF, posterior fusion, combined anterior and posterior fusion, and laminoplasty were 0.54 (0.44\u20130.68), 0.32 (0.24\u20130.44), 0.17 (0.08\u20130.38), and 0.39 (0.18\u20130.85), respectively.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The authors' analysis of the MarketScan database suggests a higher complication rate in the surgical treatment of CSM than previous national estimates. They found that elderly age (\u2265 65 years) significantly increased complication risk following ACDF and posterior fusion. Elderly patients were less likely to experience a readmission within 30 days of surgery. Postoperative complication occurrence, and 30-day readmission were significant drivers of total cost within 90 days of the index surgical procedure.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.3.focus1669","type":"journal-article","created":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T03:53:12Z","timestamp":1464753192000},"page":"E11","source":"Crossref","is-referenced-by-count":72,"title":["Surgical outcomes of cervical spondylotic myelopathy: an analysis of a national, administrative, longitudinal database"],"prefix":"10.3171","volume":"40","author":[{"given":"Anand","family":"Veeravagu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian D.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layton","family":"Lamsam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Swinney","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tej D.","family":"Azad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atman","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Ratliff","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus1669","series-title":"Eur Spine J","first-page":"2552","article-title":"Measurement of long-term outcome in patients with cervical spondylotic myelopathy treated surgically","volume":"22","author":"Al-Tamimi","year":"2013"},{"issue":"6 Suppl","key":"b2-focus1669","series-title":"Spine J","first-page":"190S","article-title":"Pathophysiology of cervical myelopathy","volume":"6","author":"Baptiste","year":"2006"},{"key":"b3-focus1669","series-title":"Neurosurgery","first-page":"455","article-title":"Cervical spondylotic myelopathy: complications and outcomes after spinal fusion","volume":"62","author":"Boakye","year":"2008"},{"key":"b4-focus1669","series-title":"Int Orthop","first-page":"273","article-title":"Neurological recovery after surgical decompression in patients with cervical spondylotic myelopathy\u2014a prospective study","volume":"32","author":"Cheung","year":"2008"},{"key":"b5-focus1669","series-title":"Eur Spine J","first-page":"2910","article-title":"Predictors of morbidity and mortality among patients with cervical spondylotic myelopathy treated surgically","volume":"24","author":"David Kaye","year":"2015"},{"key":"b6-focus1669","series-title":"Spine (Phila Pa 1976)","first-page":"1764","article-title":"Laminoplasty and pedicle screw fixation for cervical myelopathy associated with athetoid cerebral palsy: minimum 5-year follow-up","volume":"38","author":"Demura","year":"2013"},{"key":"b7-focus1669","series-title":"J Am Acad Orthop Surg","first-page":"376","article-title":"Cervical spondylotic myelopathy: diagnosis and treatment","volume":"9","author":"Emery","year":"2001"},{"key":"b8-focus1669","series-title":"J Neurosurg Spine","first-page":"425","article-title":"Perioperative and delayed complications associated with the surgical treatment of cervical spondylotic myelopathy based on 302 patients from the AOSpine North America Cervical Spondylotic Myelopathy Study","volume":"16","author":"Fehlings","year":"2012"},{"issue":"22 Suppl 1","key":"b9-focus1669","series-title":"Spine (Phila Pa 1976)","first-page":"S1","article-title":"Cervical spondylotic myelopathy: current state of the art and future directions","volume":"38","author":"Fehlings","year":"2013"},{"key":"b10-focus1669","series-title":"J Bone Joint Surg Am","first-page":"1651","article-title":"Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multicenter study","volume":"95","author":"Fehlings","year":"2013"},{"issue":"22 Suppl 1","key":"b11-focus1669","series-title":"Spine (Phila Pa 1976)","first-page":"S21","article-title":"Pathophysiology and natural history of cervical spondylotic myelopathy","volume":"38","author":"Karadimas","year":"2013"},{"key":"b12-focus1669","series-title":"Surg Neurol","first-page":"66","article-title":"National trends in spinal fusion for cervical spondylotic myelopathy","volume":"71","author":"Lad","year":"2009"},{"key":"b13-focus1669","series-title":"J Spinal Disord Tech","first-page":"135","article-title":"Modified double-door laminoplasty in managing multilevel cervical spondylotic myelopathy: surgical outcome in 520 patients and technique description","volume":"26","author":"Machino","year":"2013"},{"key":"b14-focus1669","series-title":"Spine (Phila Pa 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1976)","article-title":"Surgical treatment assessment of cervical laminoplasty using quantitative performance evaluation in elderly patients: a prospective comparative study in 505 patients with cervical spondylotic myelopathy","author":"Machino","year":"2015"},{"key":"b15-focus1669","series-title":"Cleve Clin J Med","first-page":"899","article-title":"Cervical spondylotic myelopathy: make the difficult diagnosis, then refer for surgery","volume":"70","author":"McCormick","year":"2003"},{"key":"b16-focus1669","series-title":"Neurology","first-page":"2151","article-title":"Does intraoperative neurophysiologic monitoring matter in noncomplex spine surgeries?","volume":"85","author":"Ney","year":"2015"},{"key":"b17-focus1669","series-title":"J Neurosurg Spine","first-page":"77","article-title":"A systematic review of clinical and surgical predictors of complications following surgery for degenerative cervical 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