Establishment and Preliminary Outcomes of a Nationwide Spine and Spinal Cord Surgery Registry in Japan: Analysis of 158,263 Cases in 2022.

INTRODUCTION

The Japanese Society for Spine Surgery and Related Research (JSSR) developed a national web-based registry system, integrating it with the Japanese Orthopaedic Association National Registry (JOANR/JSSR-DB) to systematically collect data on spinal and spinal cord surgeries and complications. This study aimed to report on the establishment of JOANR/JSSR-DB, and evaluate the epidemiology of spinal and spinal cord surgery in Japan, in addition to the frequency and characteristics of perioperative complications, on the basis of data from JOANR/JSSR-DB 2022.

METHODS

This registry-based study analyzed prospectively collected data in all patients who underwent spinal surgery at JSSR-certified institutions between April 1, 2022 and March 31, 2023. A total of 158,263 cases (89,358 men and 68,905 women; mean age 66.6 years) from 1,032 facilities were included. Data included demographics, diagnoses, surgical procedures, use of intraoperative supportive technologies, intraoperative and 30-day postoperative complications, and systemic complications.

RESULTS

Of the total patients, 143,085 (90.4%) underwent initial surgery, 3,712 (2.3%) staged surgery, and 11,301 (7.1%) reoperation/additional surgery. The most prevalent diagnoses were lumbar spinal canal stenosis (51,472, 32.5%), lumbar disc herniation (26,256, 16.6%), and cervical spondylotic myelopathy (15,394, 9.7%). The most common surgical procedures were posterior lumbar interbody fusion (10,910, 6.9%), posterior spinal fusion (10,826, 6.8%), and balloon kyphoplasty (8,274, 5.2%). The frequencies of intraoperative, postoperative, and systemic complications were 2.6% (4,107 patients), 2.7% (4,316 patients), and 1.8% (2,782 patients), respectively. Overall, the complication frequency was 6.5% (10,313 patients).

CONCLUSIONS

A comprehensive spine and spinal cord surgery registry was established in Japan, and a comprehensive study was conducted on diseases, surgeries, and complications related to spinal surgeries performed in 2022 in Japan. Ongoing registry-based studies are expected to enhance evidence-based practices, reduce complications, and maintain high medical care standards.

LEVEL OF EVIDENCE: 4.