Epidemiology and treatment trends in lumbar and cervical spinal canal stenosis beyond the COVID-19 pandemic - a nationwide analysis

Study DesignRetrospective, population-based cohort study ObjectiveThe global incidence of degenerative spinal canal stenosis has steadily increased in recent decades. However, comprehensive epidemiological data and trends in clinical management, especially during the COVID-19 pandemic, are lacking. We aimed to assess nationwide in-hospital treatment trends for degenerative spinal canal stenosis in Germany. MethodsData from the German Federal Statistical Office were analyzed for patients hospitalized with ICD-10 codes M48.02 (cervical) and M48.06 (lumbar) between 2014 and 2023. The acquired data was processed and analyzed using statistical modeling. ResultsThe number of patients treated for lumbar spinal canal stenosis (LSS) increased from 78,329 in 2014 to 84,507 in 2023 (p = 0.626), and for cervical spinal canal stenosis (CSS) from 12,818 to 16,590 (p = 0.003). Only the increase in CSS reached statistical significance, particularly among elderly patients after 2020. Female patients were more frequently hospitalized for both LSS and CSS. There was a trend toward shorter in-hospital stays for both groups: LSS (8.49 to 6.65 days, p < 0.001) and CSS (8.08 to 7.1 days, p < 0.001). Hypertension, diabetes, and coronary artery disease were the most common comorbidities. ConclusionsThe incidence of hospital-treated LSS and CSS has increased over the past decade. For elderly patients with CSS, treatment numbers rose significantly following the COVID-19 pandemic, possibly reflecting their vulnerability to reduced physical activity. Overall, shorter in-hospital stays and shifting surgical trends suggest evolving management strategies in degenerative spinal canal stenosis.