The Selection of Open or Percutaneous Endoscopic Lumbar Discectomy According to an Age Cut-off Point

Kim, Chi Heon; Chung, Chun Kee; Choi, Yunhee; Shin, Sora; Kim, Myo Jeong; Lee, Ju Hee; Park, Byung Joo

doi:10.1097/brs.0000000000001053

Cited by 42 publications

(55 citation statements)

References 37 publications

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“…Patients must have been diagnosed for the first between January 2008 and December 2016. We extracted only data from tertiary-referral general hospitals (3rd Hs, ≥300 beds), general hospitals (100-300 beds), hospitals (Hs, 30-100 beds), and clinics (<30 beds) to increase confidence in medical information [15][16][17][18][19] . We excluded other medical institutions where medical information was not clear.…”

Section: Data Source and Cohort Designmentioning

confidence: 99%

“…We excluded other medical institutions where medical information was not clear. Nearly all hospitals in ROK comply with the following standards of the NHIS for reimbursement: intractable painful sciatica from a disc herniation despite nonsurgical treatment for at least 6 weeks if HLD is not accompanied by neurological deficits 15,18) . However, the selection of the surgical method was at the discretion of the surgeon 15,18) .…”

Section: Data Source and Cohort Designmentioning

confidence: 99%

“…In recent years, the number of spinal surgeries for HLD performed each year has increased 6) . Open discectomy (OD) is the standard among several surgical methods used, and percutaneous endoscopic lumbar discectomy J Korean Neurosurg Soc 63 (1) : 108-118 (PELD), laminectomy, and fusion surgery are other options 12,15,18,40,[44][45][46][47] . The selection of the surgical method can largely depend on clinical and radiological factors.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the vast amount of research devoted to spinal diseases, the epidemiology of this condition is not well understood, and the overall prevalence is unclear in many countries, even in the United States 10,35) . The Republic of Korea (ROK) has a National Health Insurance Service (NHIS), a compulsory social insurance system that ensures about 97% of the population 15,17,18,36) . The remaining 3% of the population is ensured by medial aid 15,17,18,36) .…”

Section: Introductionmentioning

confidence: 99%

“…All hospitals and clinics submit the medical record to Health Insurance Review & Assessment Service (HIRA), including diagnostic and surgical codes, for review to be reimbursed for any healthcare services provided 36) . The HIRA database nationally representative and contains data on multiple variables important to epidemiological research, such as diagnosis, treatment, procedures performed, surgical history, and treatment prescriptions, thereby enabling population-based studies 15,17,18) .…”

Section: Introductionmentioning

confidence: 99%

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Trends in Incidence and Treatment of Herniated Lumbar Disc in Republic of Korea : A Nationwide Database Study

Jung

Lee

Hyun

et al. 2020

J Korean Neurosurg Soc

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Objective : This study aimed to determine the incidence and analyze trends of the herniated lumbar disc (HLD) based on a national database in the Republic of Korea (ROK) from January 2008 to December 2016. Methods : This study was a retrospective analysis of data obtained from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and agestandardized incidence of HLD were calculated, and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and some treatments were analyzed using the Korean Classification of Diseases procedure codes. Results : The number of patients diagnosed with HLD was 472245 in 2008 and increased to 537577 in 2012; however, it decreased to 478697 in 2016. The pattern of crude incidence and the standardized incidence were also similar. Overall, the incidence of HLD increased annually for the 30s, 40s, 50s, and 70s until 2012 and then decreased. However, the incidence of HLD for the 80s continued to increase. The crude incidence of HLD in female patients exceeded that of male patients in their middle age (30s or 40s) and was 1.5-1.6 times higher than in male patients in their 60s. The total number of open discectomy (OD) increased from 71598 in 2008 to 93942 in 2012 and then decreased to 85846 in 2016. The rate of younger patients (the 20s, 30s, and 40s) who underwent OD was decreased, and the rate of younger patients who underwent percutaneous endoscopic lumbar discectomy was increased. However, the rate of older patients (the 70s and 80s) who underwent OD was continuously increased. Conclusion : This nationwide data on HLD from 2008 to 2016 in the ROK demonstrated that the crude incidence and the standardized incidence increased until 2012 and then decreased. The annual crude incidence was different according to age and sex. These findings may be considered when deciding future health policy, especially in countries with a similar national health insurance system (or with plans to adopt). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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