Nationwide Trends and Safety Analysis of Adult Spinal Instrumentation Surgery: A Study using the JSIS-DB

Area of Science:

• Spine Surgery
• Epidemiology
• Patient Safety

Background:

• Spinal instrumentation surgery is increasingly common in aging populations.
• Nationwide data on trends and safety of these procedures in Japan are limited.

Purpose of the Study:

• To evaluate epidemiological characteristics of adult spinal instrumentation surgery in Japan.
• To assess perioperative safety and complication profiles using the Japanese Spinal Instrumentation Society Database (JSIS-DB).

Main Methods:

• Retrospective observational study using JSIS-DB data (2018-2022).
• Included adults (≥18 years) undergoing spinal surgeries with intervertebral instrumentation.
• Analyzed demographic data, diagnoses, procedures, operative details, and complications within 14 days.

Main Results:

• 28,832 cases analyzed (mean age 67.3 years).
• Most common diagnosis: degenerative disease (62.9%). Most frequent procedure: posterior lumbar interbody fusion (40.8%).
• Overall complication rate: 11.0%. Higher rates in patients ≥90 years (18.6%) and those with deformities (13.9%), infections (13.4%), or tumors (13.3%).

Conclusions:

• Nationwide registry data provide real-world insights into adult spinal instrumentation surgery in Japan.
• Elderly patients and those with specific pathologies (deformities, infections, tumors) have elevated perioperative risks.
• Findings emphasize the need for enhanced preoperative assessment and perioperative care to improve surgical safety and quality.