{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:15:49Z","timestamp":1780071349595,"version":"3.54.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Clear diagnostic delineation is necessary for the development of a strong evidence base in lumbar spinal surgery. Experience with existing national databases suggests that <jats:italic>International Classification of Diseases, Tenth Edition<\/jats:italic> (ICD-10) coding is insufficient to support that need. The purpose of this study was to assess agreement between surgeon-specified diagnostic indication and hospital-reported ICD-10 codes for lumbar spine surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Data collection for the American Spine Registry (ASR) includes an option to denote the surgeon\u2019s specific diagnostic indication for each procedure. For cases treated between January 2020 and March 2022, surgeon-delineated diagnosis was compared with the ICD-10 diagnosis generated by standard ASR electronic medical record data extraction. For decompression-only cases, the primary analysis focused on the etiology of neural compression as determined by the surgeon versus that determined on the basis of the related ICD-10 codes extracted from the ASR database. For lumbar fusion cases, the primary analysis compared structural pathology, which may have required fusion, as determined by the surgeon versus that determined on the basis of the extracted ICD-10 codes. This allowed for identification of agreement between surgeon delineation and extracted ICD-10 codes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In 5926 decompression-only cases, agreement between the surgeon and ASR ICD-10 codes was 89% for spinal stenosis and 78% for lumbar disc herniation and\/or radiculopathy. Both the surgeon and database indicated no structural pathology (i.e., none) suggesting the need for fusion in 88% of cases. In 5663 lumbar fusion cases, agreement was 76% for spondylolisthesis but poor for other diagnostic indications.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Agreement between surgeon-specified diagnostic indication and hospital-reported ICD-10 codes was best for patients who underwent decompression only. In the fusion cases, agreement with ICD-10 codes was best in the spondylolisthesis group (76%). In cases other than spondylolisthesis, agreement was poor due to multiple diagnoses or lack of an ICD-10 code that reflected the pathology. This study suggested that standard ICD-10 codes may be inadequate to clearly define the indications for decompression or fusion in patients with lumbar degenerative disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.4.spine23135","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T15:47:18Z","timestamp":1684597638000},"page":"404-410","source":"Crossref","is-referenced-by-count":5,"title":["Surgeon input can increase the value of registry data: early experience from the American Spine Registry"],"prefix":"10.3171","volume":"39","author":[{"given":"Steven D.","family":"Glassman","sequence":"first","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah Y.","family":"Carreon","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates and Neurological Institute, Carolinas Healthcare System, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayushmita","family":"De","sequence":"additional","affiliation":[{"name":"American Academy of Orthopaedic Surgeons, Rosemont, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Mullen","sequence":"additional","affiliation":[{"name":"American Academy of Orthopaedic Surgeons, Rosemont, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly R.","family":"Porter","sequence":"additional","affiliation":[{"name":"American Academy of Orthopaedic Surgeons, Rosemont, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Duke University Medical Center, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Knightly","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Sciences Center, Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J.","family":"Albert","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrel S.","family":"Brodke","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Polly","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Spine J","first-page":"747","article-title":"Fusion and nonsurgical treatment for symptomatic lumbar degenerative disease: a systematic review of Oswestry Disability Index and MOS Short Form-36 outcomes","volume":"8","author":"Carreon LY","year":"2008","unstructured":"Carreon LY, Glassman SD, Howard J. Fusion and nonsurgical treatment for symptomatic lumbar degenerative disease: a systematic review of Oswestry Disability Index and MOS Short Form-36 outcomes. Spine J. 2008;8(5):747\u2013755."},{"issue":"4","key":"b2","series-title":"Clin Spine Surg","first-page":"E230","article-title":"Radiographic and clinical outcomes of anterior and transforaminal lumbar interbody fusions: a systematic review and meta-analysis of comparative studies","volume":"31","author":"Ajiboye RM","year":"2018","unstructured":"Ajiboye RM, Alas H, Mosich GM, Sharma A, Pourtaheri S. Radiographic and clinical outcomes of anterior and transforaminal lumbar interbody fusions: a systematic review and meta-analysis of comparative studies. Clin Spine Surg. 2018;31(4):E230\u2013E238."},{"issue":"5","key":"b3","series-title":"Arch Orthop Trauma Surg","first-page":"637","article-title":"Effectiveness of decompression alone versus decompression plus fusion for lumbar spinal stenosis: a systematic review and meta-analysis","volume":"137","author":"Chang W","year":"2017","unstructured":"Chang W, Yuwen P, Zhu Y,  Effectiveness of decompression alone versus decompression plus fusion for lumbar spinal stenosis: a systematic review and meta-analysis. Arch Orthop Trauma Surg. 2017;137(5):637\u2013650."},{"issue":"3","key":"b4","series-title":"PLoS One","first-page":"e0122800","article-title":"Effectiveness of surgery for lumbar spinal stenosis: a systematic review and meta-analysis","volume":"10","author":"Machado GC","year":"2015","unstructured":"Machado GC, Ferreira PH, Harris IA,  Effectiveness of surgery for lumbar spinal stenosis: a systematic review and meta-analysis. PLoS One. 2015;10(3):e0122800."},{"issue":"12","key":"b5","series-title":"Intern Med J","first-page":"1430","article-title":"Lumbar spine fusion: what is the evidence?","volume":"48","author":"Harris IA","year":"2018","unstructured":"Harris IA, Traeger A, Stanford R, Maher CG, Buchbinder R. Lumbar spine fusion: what is the evidence?. Intern Med J. 2018;48(12):1430\u20131434."},{"issue":"5","key":"b6","series-title":"Neurosurgery","first-page":"701","article-title":"Lumbar fusion for degenerative disease: a systematic review and meta-analysis","volume":"80","author":"Yavin D","year":"2017","unstructured":"Yavin D, Casha S, Wiebe S,  Lumbar fusion for degenerative disease: a systematic review and meta-analysis. Neurosurgery. 2017;80(5):701\u2013715."},{"issue":"4","key":"b7","series-title":"Am J Orthop","first-page":"175","article-title":"Lumbar degenerative classification study","volume":"35","author":"Glassman SD","year":"2006","unstructured":"Glassman SD, Carreon LY, Dimar JR, Campbell MJ, Johnson JR, Puno RM. Lumbar degenerative classification study. Am J Orthop. 2006;35(4):175\u2013179."},{"issue":"12","key":"b8","series-title":"Spine J","first-page":"1934","article-title":"Interobserver variance and patient heterogeneity influencing the treatment of grade I spondylolisthesis","volume":"20","author":"Resnick DK","year":"2020","unstructured":"Resnick DK, Schmidt BT, Momin E, Hetzel SJ, Ghogawala Z. Interobserver variance and patient heterogeneity influencing the treatment of grade I spondylolisthesis. Spine J. 2020;20(12):1934\u20131939."},{"key":"b9","article-title":"American Spine Registry","unstructured":"American Spine Registry. Accessed April 26, 2023.https:\/\/www.americanspineregistry.org"},{"issue":"7","key":"b10","series-title":"Medicine (Baltimore)","first-page":"e14410","article-title":"Comparison of treatments for lumbar disc herniation: systematic review with network meta-analysis","volume":"98","author":"Arts MP","year":"2019","unstructured":"Arts MP, Kur\u0161umovi\u0107 A, Miller LE,  Comparison of treatments for lumbar disc herniation: systematic review with network meta-analysis. Medicine (Baltimore). 2019;98(7):e14410."},{"issue":"19","key":"b11","series-title":"Health Technol Assess","first-page":"1","article-title":"The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model","volume":"17","author":"Beynon R","year":"2013","unstructured":"Beynon R, Hawkins J, Laing R,  The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model. Health Technol Assess. 2013;17(19):1-88,v-vi."},{"issue":"1","key":"b12","series-title":"Spine J","first-page":"143","article-title":"The influence of subgroup diagnosis on radiographic and clinical outcomes after lumbar fusion for degenerative disc disorders revisited: a systematic review of the literature","volume":"17","author":"Bhalla A","year":"2017","unstructured":"Bhalla A, Schoenfeld AJ, George J, Moghimi M, Bono CM. The influence of subgroup diagnosis on radiographic and clinical outcomes after lumbar fusion for degenerative disc disorders revisited: a systematic review of the literature. Spine J. 2017;17(1):143\u2013149."},{"issue":"6","key":"b13","series-title":"N Engl J Med","first-page":"526","article-title":"Decompression with or without fusion in degenerative lumbar spondylolisthesis","volume":"385","author":"Austevoll IM","year":"2021","unstructured":"Austevoll IM, Hermansen E, Fagerland MW,  Decompression with or without fusion in degenerative lumbar spondylolisthesis. N Engl J Med. 2021;385(6):526\u2013538."},{"issue":"15","key":"b14","series-title":"N Engl J Med","first-page":"1413","article-title":"A randomized, controlled trial of fusion surgery for lumbar spinal stenosis","volume":"374","author":"F\u00f6rsth P","year":"2016","unstructured":"F\u00f6rsth P, \u00d3lafsson G, Carlsson T,  A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016;374(15):1413\u20131423."},{"issue":"15","key":"b15","series-title":"N Engl J Med","first-page":"1424","article-title":"Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis","volume":"374","author":"Ghogawala Z","year":"2016","unstructured":"Ghogawala Z, Dziura J, Butler WE,  Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis. N Engl J Med. 2016;374(15):1424\u20131434."},{"issue":"11","key":"b16","series-title":"Spine J","first-page":"1778","article-title":"Current treatment and decision-making factors leading to fusion vs decompression for one-level degenerative spondylolisthesis: survey results from members of the Lumbar Spine Research Society and Society of Minimally Invasive Spine Surgery","volume":"22","author":"Morse KW","year":"2022","unstructured":"Morse KW, Steinhaus M, Bovonratwet P,  Current treatment and decision-making factors leading to fusion vs decompression for one-level degenerative spondylolisthesis: survey results from members of the Lumbar Spine Research Society and Society of Minimally Invasive Spine Surgery. 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Arch Orthop Trauma Surg. 2019;139(5):613\u2013621."},{"issue":"10","key":"b19","series-title":"Spine (Phila Pa 1976)","first-page":"797","article-title":"Single- versus multilevel fusion for single-level degenerative spondylolisthesis and multilevel lumbar stenosis: four-year results of the spine patient outcomes research trial","volume":"38","author":"Smorgick Y","year":"2013","unstructured":"Smorgick Y, Park DK, Baker KC,  Single- versus multilevel fusion for single-level degenerative spondylolisthesis and multilevel lumbar stenosis: four-year results of the spine patient outcomes research trial. Spine (Phila Pa 1976). 2013;38(10):797\u2013805."},{"issue":"9","key":"b20","series-title":"Clin Spine Surg","first-page":"316","article-title":"A primer on the use of artificial intelligence in spine surgery","volume":"34","author":"Katsuura Y","year":"2021","unstructured":"Katsuura Y, Col\u00f3n LF, Perez AA, Albert TJ, Qureshi SA. A primer on the use of artificial intelligence in spine surgery. Clin Spine Surg. 2021;34(9):316\u2013321."},{"key":"b21","series-title":"World Neurosurg","first-page":"512","article-title":"Use of machine learning and artificial intelligence to drive personalized medicine approaches for spine care","volume":"140","author":"Khan O","year":"2020","unstructured":"Khan O, Badhiwala JH, Grasso G, Fehlings MG. Use of machine learning and artificial intelligence to drive personalized medicine approaches for spine care. World Neurosurg. 2020;140:512\u2013518."},{"issue":"2","key":"b22","series-title":"Global Spine J","first-page":"135","article-title":"Intelligence-based spine care model: a new era of research and clinical decision-making","volume":"11","author":"Mallow GM","year":"2021","unstructured":"Mallow GM, Siyaji ZK, Galbusera F,  Intelligence-based spine care model: a new era of research and clinical decision-making. Global Spine J. 2021;11(2):135\u2013145."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/3\/article-p404.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/3\/article-p404.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/3\/article-p404.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:13:55Z","timestamp":1733490835000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/3\/article-p404.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":22,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2023.4.spine23135","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9,1]]}}}