• Paolo A Cortesi, Roberto Assietti, Fabrizio Cuzzocrea, Domenico Prestamburgo, Mauro Pluderi, Paolo Cozzolino, Patrizia Tito, Roberto Vanelli, Davide Cecconi, Stefano Borsa, Giancarlo Cesana, and Lorenzo G Mantovani.
• *Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy †Neurosurgery Operative Unit, Ospedale Fatebenefratelli e Oftalmico, ASST Fatebenefratelli Sacco, Milan, Italy ‡Orthopaedics and Traumatology Clinic, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy §Orthopaedic & Trauma I Unit, Ospedale Civile di Legnano, ASST Ovest Milanese, Legnano Italy ¶Neurosurgery Unit, Fondazione I.R.C.C.S. "Ca' Granda" Ospedale Maggiore Policlinico, Milan, Italy.
• Spine. 2017 Feb 9.

Study DesignRetrospective large population based-study OBJECTIVE.: Assessment of the epidemiologic trends and economic burden of first spinal fusions.Summary Of Background DataNo adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe.MethodsThe study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region. The study population consisted of all subjects, resident in Lombardy, who, during the period January 2001-December 2010, underwent spinal fusion surgery (ICD9-CM codes: 81.04, 81.05, 81.06, 81.07 and 81.08). The first procedure was used as the index event. We estimated the incidence of first spinal fusion surgery, the population and surgery characteristics and the healthcare costs from the National Health Service's perspective. The analysis was performed for the entire population and divided into the main groups of diagnosis.ResultsThe analysis identified 17,772 (mean(SD) age 54.6(14.5), 55.3% female) spinal fusion surgeries. Almost 67% of the patients suffered from a Lumbar Degenerative Disease. The incidence rate of interventions increased from 11.5 to 18.5 per 100,000 person-year between 2001 and 2006, and was above 20.0 per 100,000 person-year in the last 4 years. The patients' mean age increased during the observational time period from 48.1 to 55.9 years; while the median hospital length of stay reported for the index event decreased. The average cost of the spinal fusion surgery increased during the observational period, from &OV0556; 4,726 up to &OV0556; 9,388.ConclusionsThe study showed an increasing incidence of spinal fusion surgery and costs from 2001 to 2010. These results can be used to better understand the epidemiological and economic burden of these interventions, and help to optimize the resources available considering the different clinical approaches accessible today.Level Of Evidence4.

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