• Steven D Glassman, Mladen Djurasovic, Anthony L Asher, Ayushmita De, Jayson Murray, Aleeza Safdar, Kimberly R Porter, and Mohamad Bydon.
• Norton Leatherman Spine Center, Louisville, KY, USA.
• Spine. 2025 Jan 29.

Study DesignRetrospective observational study.ObjectiveTo evaluate whether the combined American Spine Registry and Medicare (ASR/CMS) data yields substantially different findings versus ASR data alone with regard to key parameters such as risk stratification, complication rates and readmission rates in lumbar surgery investigated through an analysis of 8,755 spondylolisthesis cases.Summary Of Background DataMedicare data correlation has been effective for determining revision rates for other procedures such as total hip replacement. Our aim is to determine whether these findings are translatable in the realm of lumbar spinal surgery investigated through an analysis of 8,755 spondylolisthesis cases.MethodsThe American Spine Registry (ASR) was queried for Medicare-eligible patients who underwent lumbar spinal fusion for lumbar spondylolisthesis. This cohort was analyzed based upon ASR data alone in comparison to the same patients in the combined ASR/Medicare (ASR/CMS) dataset. The primary outcome of interest was readmission at 30 and 90 days postoperatively.ResultsThere were 8,755 Medicare-eligible cases with a diagnosis of spondylolisthesis within the ASR. The mean age was 72.7 years, 60.8% were female. Medical comorbidities were more frequently detected in the combined ASR/CMS dataset, reflected by a higher mean Charlson Comorbidity Index score (3.49 vs. 3.27, P<0.001). Hospital readmission rates were significantly higher in the combined ASR/CMS dataset at both 30 days (4.89% vs. 1.83%, P<0.001) and 90 days (7.68% vs. 2.66%, P<0.001), with notable increases in readmissions for infections and medical complications. Discharge disposition remained comparable across datasets, with most patients discharged to home or home health care.ConclusionThis study demonstrates that integrating patient-identified Medicare data with the ASR provides a more comprehensive assessment of outcomes for lumbar spinal fusion surgery as demonstrated through an analysis of 8,755 spondylolisthesis cases. These findings, establish the importance of multi-source data linkage to overcome the limitations of single-source registries, thereby enhancing data quality for clinical decision-making and quality improvement in spinal surgery.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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