LAUSR

OBJECTIVE To predict surgical volumes for two common cervical spine procedures from 2020 to 2040. METHODS Utilizing the National Inpatient Sample from 2003-2016, nationwide estimates of anterior cervical discectomy and fusion (ACDF) and posterior cervical decompression and fusion (PCDF) volumes were calculated using International Classification of Diseases, Ninth and Tenth Revision (ICD-9, ICD-10) procedure codes. With data from the United States Census Bureau, estimates of the United States population were used to create Poisson models controlling for age and sex. Age was categorized into ranges (<25 years old, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and >85), and estimates of surgical volume for each age group were created. RESULTS From 2020-2040, increases in surgical volume from 13.3% (153,288 to 173,699) and 19.3% (29,620 to 35,335) are expected for ACDF and PCDF, respectively. For ACDF, the largest increases are expected in the 45-54 (42,077 to 49,827) and 75-84 (8,065 to 14,862) age groups, whereas for PCDF, the largest increases will be seen in the 75-84 (3,710 to 6,836) group. In accordance with an aging population, modest increases will be seen for ACDF (858 to 1,847) and PCDF (730 to 1,573) in the >85 years old cohort. CONCLUSION As expected, large growth in cervical spine surgical volumes is likely to be seen, which could indicate a need for increased numbers of spinal neurosurgeons and orthopedic surgeons. Further studies are needed to investigate the needs of the field in light of these expected increases in volume.