A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery: National use, regional variation, and patient outcomes

Whitney Sheen James, Anand I. Rughani, Travis M Dumont

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Object. In the United States in recent years, a dramatic increase in the use of intraoperative neurophysiological monitoring (IONM) during spine surgeries has been suspected. Myriad reasons have been proposed, but no clear evidence confirming this trend has been available. In this study, the authors investigated the use of IONM during spine surgery, identified patterns of geographic variation, and analyzed the value of IONM for spine surgery cases. Methods. In this retrospective analysis, the Nationwide Inpatient Sample was queried for all spine surgeries performed during 2007-2011. Use of IONM (International Classification of Diseases, Ninth Revision, code 00.94) was compared over time and between geographic regions, and its effect on patient independence at discharge and iatrogenic nerve injury was assessed. Results. A total of 443,194 spine procedures were identified, of which 85% were elective and 15% were not elective. Use of IONM was recorded for 31,680 cases and increased each calendar year from 1% of all cases in 2007 to 12% of all cases in 2011. Regional use of IONM ranged widely, from 8% of cases in the Northeast to 21% of cases in the West in 2011. Iatrogenic nerve and spinal cord injury were rare; they occurred in less than 1% of patients and did not significantly decrease when IONM was used. Conclusions. As costs of spine surgeries continue to rise, it becomes necessary to examine and justify use of different medical technologies, including IONM, during spine surgery.

Original languageEnglish (US)
Article numberE10
JournalNeurosurgical Focus
Volume37
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Intraoperative Neurophysiological Monitoring
Spine
International Classification of Diseases
Spinal Cord Injuries
Inpatients
Technology

Keywords

  • Neurophysiological monitoring
  • Socioeconomics
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery : National use, regional variation, and patient outcomes. / James, Whitney Sheen; Rughani, Anand I.; Dumont, Travis M.

In: Neurosurgical Focus, Vol. 37, No. 5, E10, 2014.

Research output: Contribution to journalArticle

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