Aging population projected to increase use of spinal fusion, strain German health care
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Projections showed a decreasing and aging working population along with increasing demand and costs of posterior spinal fusion may challenge the German health care system.
Vincent J. Heck, MD, and colleagues used nationwide data from the German Federal Statistical Office to analyze trends of posterior spinal fusion procedures from 2005 to 2019 and projected incidence rates and costs for 2020 to 2060. They quantified posterior spinal fusion rates as a function of calendar year, age and gender, according to the study.
Researchers found the incidence rate of posterior spinal fusion per 100,000 inhabitants was projected to increase from 83% to 102% by 2060. Patients aged 75 years and older were projected to undergo 38,974 posterior spinal fusions compared with 14,657 posterior spinal fusions in 2019 – totaling a 246% increase for women and a 296% increase for men. Researchers also projected posterior spinal fusions in patients aged 55 years and younger to follow a constant or even negative incidence trend by 2060.
“Given the known risk factors associated with the surgical treatment of older patients, we think anticipatory human and financial resource planning, frailty as a focus of research and the development of interinstitutional protocols that focus on effective perioperative medical care for these patients will be important elements of managing these trends in the future,” the researchers wrote in the study. “Because many other developed countries have shown comparable procedure-specific trends in the past and will face similar demographic changes in the future, these findings are likely to challenge the German health care system and many other health care systems worldwide,” they concluded.
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