Technical Advancements and Utilization of Spine Surgery  -International Disparities in Trend-Dynamics Between Japan, Korea, and the USA

Kim, Phyo; Kurokawa, Ryu; Itoki, Kazushige

doi:10.2176/nmc.50.853

Cited by 27 publications

(6 citation statements)

References 61 publications

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“…These include demographic changes such as an ageing population, rise in obesity, sedentary lifestyles, public health factors such as changes in health guidelines, and surgical factors such as advancements in diagnostic imaging and proliferation of spinal instrumentation and implant systems. 7 23 …”

Section: Discussionmentioning

confidence: 99%

Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

et al. 2015

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ObjectivesLow back pain (LBP), from degenerative lumbar spine disease, represents a significant burden on healthcare resources. Studies worldwide report trends attributable to their country's specific demographics and healthcare system. Considering England's specific medico-socioeconomic conditions, we investigate recent trends in hospital admissions and procedures for LBP, and discuss the implications for the allocation of healthcare resources.DesignRetrospective cohort study using Hospital Episode Statistics data relating to degenerative lumbar spine disease in England, between 1999 and 2013. Regression models were used to analyse trends.Outcome measuresTrends in the number of admissions and procedures for LBP, mean patient age, gender and length of stay.ResultsHospital admissions and procedures have increased significantly over the study period, from 127.09 to 216.16 and from 24.5 to 48.83 per 100 000, respectively, (p<0.001). The increase was most marked in the oldest age groups with a 1.9 and 2.33-fold increase in admissions for patients aged 60–74 and ≥75 years, respectively, and a 2.8-fold increase in procedures for those aged ≥60 years. Trends in hospital admissions were characterised by a widening gender gap, increasing mean patient age, and decreasing mean hospital stay (p<0.001). Trends in procedures were characterised by a narrowing gender gap, increasing mean patient age (p=0.014) and decreasing mean hospital stay (p<0.001). Linear regression models estimate that each hospital admission translates to 0.27 procedures, per 100 000 (95% CI 0.25 to 0.30, r 0.99, p<0.001; r, Pearson's correlation coefficient). Hospital admissions are increasing at 3.5 times the rate of surgical procedures (regression gradient 7.63 vs 2.18 per 100 000/year).ConclusionsLBP represents a significant and increasing workload for hospitals in England. These trends demonstrate an increasing demand for specialists involved in the surgical and non-surgical management of this disease, and highlight the need for services capable of dealing with the increased comorbidity burden associated with an ageing patient group.

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Section: Discussionmentioning

confidence: 99%

Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

et al. 2015

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“…The reasons behind such steep increase are multiple and include broader surgical indications, shorter operative durations and significant technological improvements. Moreover, the greater life expectancy of the population and the decrease of post-surgical complication rates have led a growing number of elderlies with DS in their eighties to demand for spinal fusion [15,23,29]. It becomes therefore essential to balance benefits and potential complications in these age categories commonly considered as fragile and at risk for such invasive procedures.…”

Section: Introductionmentioning

confidence: 99%

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

et al. 2022

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Purpose Degenerative spondylolisthesis (DS) is a debilitating condition that carries a high economic burden. As the global population ages, the number of patients over 80 years old demanding spinal fusion is constantly rising. Therefore, neurosurgeons often face the important decision as to whether to perform surgery or not in this age group, commonly perceived at high risk for complications. Methods Six hundred seventy-eight elder patients, who underwent posterolateral lumbar fusion for DS (performed in three different centers) from 2012 to 2020, were screened for medical, early and late surgical complications and for the presence of potential preoperative risk factors. Patients were divided in three categories based on their age: (1) 60–69 years, (2) 70–79 years, (3) 80 and over. Multiple logistic regression was used to determine the predictive power of age and of other risk factors (i.e., ASA score; BMI; sex; presence or absence of insulin-dependent and -independent diabetes, use of anticoagulants, use of antiaggregants and osteoporosis) for the development of postoperative complications. Results In univariate analysis, age was significantly and positively correlated with medical complications. However, when controls for other risk factors were added in the regressions, age never reached significance, with the only noticeable exception of cerebrovascular accidents. ASA score and BMI were the two risk factors that significantly correlated with the higher numbers of complication rates (especially medical). Conclusion Patients of different age but with comparable preoperative risk factors share similar postoperative morbidity rates. When considering octogenarians for lumbar arthrodesis, the importance of biological age overrides that of chronological.

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“…The incidence of spine surgery is estimated to be 1,800–2,050 and 400–725 million person-years in the United States and Japan, respectively [ 1 ]. According to research based on Medicare in the United States, the average rate of lumbar fusion increased by three-fold between 1992 and 2003 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Histological Changes in Back Muscle Injuries in Rats over Time

et al. 2017

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Study DesignAnimal model study.PurposeThe purpose of this study was to evaluate the histological variation in the injured muscle and production of calcitonin gene-related peptide in rats over time.Overview of LiteratureVertebral surgery has been reported to cause atrophy of the back muscles, which may result in pain. However, few reports have described the time series histological variation in the injured muscle and changes in the dominant nerve.MethodsWe used 30 male, 8-week-old Sprague-Dawley rats. The right and left sides of the paravertebral muscle were considered as the injured and uninjured sides, respectively. A 115 g weight was dropped from a height of 1 m on the right paravertebral muscle. Hematoxylin and eosin (H&E) staining of the muscle was performed 1–3 weeks after injury for histological evaluation. Fluoro-Gold (FG) was injected into the paravertebral muscle. The L2 dorsal root ganglia on both sides were resected 1, 2, and 3 weeks after injury, and immunohistochemical staining for calcitonin gene-related peptide was performed.ResultsH&E staining of the paravertebral muscle showed infiltration of inflammatory cells and the presence of granulation tissue in the injured part on the ipsilateral side 1 week after injury. Muscle atrophy occurred 3 weeks after injury, but was repaired via spontaneous replacement of muscle cells/fibers. In contrast, compared with the uninjured side, the percentage of cells double-labeled with FG and calcitonin gene-related peptide in FG-positive cells in the dorsal root ganglia of the injured side was significantly increased at each time point throughout the study period.ConclusionsThese results suggest that sensitization of the dominant nerve in the dorsal root ganglia, which may be caused by cicatrix formation, can protract injured muscle pain. This information may be helpful in elucidating the underlying mechanism of persistent pain after back muscle injury.

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Technical Advancements and Utilization of Spine Surgery -International Disparities in Trend-Dynamics Between Japan, Korea, and the USA

Cited by 27 publications

References 61 publications

Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

Evaluation of Histological Changes in Back Muscle Injuries in Rats over Time

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