Analysis of Conservative Treatment Trends for Lumbar Disc Herniation with Radiculopathy in Korea: A Population-Based Cross-Sectional Study

Abstract

This study aimed to analyze the trends in conservative treatment and associated medical costs for lumbar intervertebral disc disorders with radiculopathy in Korea. This population-based cross-sectional study included patients aged ≥ 20 years with at least one “intervertebral disc disorder with radiculopathy” claim (Korean Standard Classification of Diseases (KCD)-7 code: M511) who sought treatment from tertiary, general, or Korean Medicine hospitals or clinics between 2010 and 2019 and whose data were extracted from the Korean Health Insurance Review and Assessment Service National Patients Sample database. Intervention frequency, ratio, and medical costs, including medication, were analyzed. The number of patients with lumbar intervertebral disc disorders and radiculopathy undergoing conservative treatment increased by >30%, and medical costs increased from USD 3,342,907 to USD 5,600,456 during the 10-year period. The non-surgical treatments mainly used were medication and physiotherapy, and the most commonly prescribed medication was non-opioid analgesics. Meanwhile, the number of patients who used nerve plexus and root and ganglion nerve blocks showed the most significant increase. In conclusion, the number of patients with radiculopathy who received nerve blocks, particularly nerve plexus and root and ganglion nerve blocks, and related expenditure increased, implying a gradual shift in medical decisions from systemic pain reduction to specific and targeted pain treatments. Future studies and clinical practice guidelines may require further inspection of real-world practice to advise optimal treatment choices for an effective treatment plan.

Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

“…LDH can limit mobility and the ability to perform physical activities, and cause disability ( 4 ), thereby reducing the quality of life of patients and increasing medical costs. Although conservative treatment is the first choice for treating LDH, surgery is necessary for severe LDH to achieve good clinical outcomes ( 5 , 6 ).…”

Open revision after minimally invasive lumbar transforaminal endoscopic surgery: A case report and literature review

“…Lumbar Disc Herniation (LDH) is more prevalent among middle-aged and elderly individuals. It is a clinical syndrome caused by the degeneration of lumbar intervertebral disc tissue and the stimulation or compression of nerve roots due to the rupture of the annulus fibrosus and the protrusion of the nucleus pulposus as a result of various factors [1]. Major signs and symptoms of LDH include radicular pain, paresthesia, and weakness in the distribution of one or more lumbosacral nerve roots.…”