Effects of fusion and conservative treatment on @entity1797 and rates of subsequent surgery after thoracolumbar XXXX .

@entity1 @entity1797 @entity179 @entity174
UNASSIGNED: OBJECT The objective of this study was to compare the incidence of degeneration and need for subsequent fusion surgery between @entity1 who were treated nonsurgically and @entity1 treated with fusion after a diagnosis of thoracic-or lumbar-level @entity174 without @entity179 . METHODS The authors performed a retrospective study of Orthopedic United Healthcare @entity1 diagnosed with @entity174 . @entity1 were filtered into thoracic and @entity174 groups using diagnostic codes and then assigned to one of 2 treatment subgroups (fusion surgery or no surgery) on the basis of procedural codes. @entity1797 and follow-up surgery were recorded. Chi-square statistical analysis was used. RESULTS Of 3699 @entity1 diagnosed with a thoracic @entity174 , 117 (3.2%) underwent thoracic fusion and 3215 (86.9%) were treated nonsurgically. Within 3 years, 147 (4.6%) @entity1 from the nonsurgical subgroup and fewer than 11 (0.9%-8.5%) from the fusion subgroup were diagnosed with @entity1797 . From the nonsurgical subgroup, 11 (0.3%) @entity1 underwent a thoracic surgery related to @entity1797 compared with zero from the fusion group (p > 0.05). Of 5016 @entity1 diagnosed with @entity174 , 150 (3.0%) underwent fusion and 4371 (87.1%) had no surgery. Within 3 years, 503 @entity1 (11.5%) from the nonsurgical subgroup and 35 (23.3%) from the fusion subgroup were diagnosed with @entity1797 (p < 0.05). From the nonsurgical subgroup, 42 (1.0%) went on to have surgery related to @entity1797 , compared with fewer than 11 (0.7%-6.7%) from the fusion subgroup (values not precise due to privacy limitations). CONCLUSIONS Fusion surgery for thoracic @entity174 does not appear to increase the likelihood of undergoing future surgery. In the lumbar region, initial fusion surgery appears to increase the incidence of @entity1797 and could potentially necessitate future surgeries.
