The Rates of LSS Surgery in Norwegian Public Hospitals

Grøvle, Lars; Fjeld, Olaf Randall; Haugen, Anne Julsrud; Helgeland, Jon; Småstuen, Milada Cvancarova; Zwart, John‐Anker; Grotle, Margreth

doi:10.1097/brs.0000000000002858

Cited by 18 publications

(18 citation statements)

References 39 publications

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“…In line with Davis, our results demonstrate that more men than women received lumbar spine surgery. Several studies on the rates of different types of spinal surgery, such as disc herniation and spinal fusion surgery, have been published 2–11 22. In general, the findings in the present paper are in accordance with the other studies from Scandinavian countries3 5 and Germany,6 which show increased rates for lumbar disc herniation and spinal stenosis surgery.…”

Section: Discussionsupporting

confidence: 91%

Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway

Grotle

Småstuen

Fjeld³

et al. 2019

BMJ Open

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134

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BackgroundStudies from different Western countries have reported a rapid increase in spinal surgery rates, an increase that exceeds by far the growing incidence rates of spinal disorders in the general population. There are few studies covering all lumbar spine surgery and no previous studies from Norway.ObjectivesThe purpose of this study was to investigate trends in all lumbar spine surgery in Norway over 15 years, including length of hospital stay, and rates of complications and reoperations.DesignA longitudinal observational study over 15 years using hospital patient administrative data and sociodemographic data from the National Registry in Norway.Setting and participantsPatients aged ≥18 years discharged from Norwegian public hospitals between 1999 and 2013.Outcome measuresAnnual rates of simple (microsurgical discectomy, decompression) and complex surgical procedures (fusion, disc prosthesis) in the lumbar spine.ResultsThe rate of lumbar spine surgery increased by 54%, from 78 (95% CI (75 to 80)) to 120 (107 to 113) per 100 000, from 1999 to 2013. More men had simple surgery whereas more women had complex surgery. Among elderly people over 75 years, lumbar surgery increased by a factor of five during the 15-year period. The rates of complications were low, but increased from 0.7% in 1999 to 2.4% in 2013.ConclusionsThere was a substantial increase in lumbar spine surgery in Norway from 1999 to 2013, similar to trends in other Western world countries. The rise in lumbar surgery among elderly people represents a significant workload and challenge for health services, given our aging population.

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Section: Discussionsupporting

confidence: 91%

Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway

Grotle

Småstuen

Fjeld³

et al. 2019

BMJ Open

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134

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“…The 144% increase in decompression surgery rates in Denmark (5.7% yearly) is lower than in a comparable study from Norway showing a 238% increase in decompression surgery from 1999 to 2013 (9.1% yearly) ( 14 ). Compared with the Scandinavian studies, an Australian study ( 15 ) investigating surgery rates for LSS from 2003 to 2013 reported an increase of only 31% (2.7% yearly).…”

Section: Discussionmentioning

confidence: 56%

“…Compared with the Scandinavian studies, an Australian study ( 15 ) investigating surgery rates for LSS from 2003 to 2013 reported an increase of only 31% (2.7% yearly). At the end of the data collection period (2013), the Norwegian study ( 14 ) reported a decompression surgery rate with or without fusion of 39 per 100,000, and the Australian study ( 15 ) had a surgery rate of 27 per 100,000. The surgery rate for decompression with or without fusion in Denmark in 2013 was 49 per 100,000 and thus comparable to Norway, although about 25% higher.…”

Section: Discussionmentioning

confidence: 99%

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Surgery rates for lumbar spinal stenosis in Denmark between 2002 and 2018: a registry-based study of 43,454 patients

Jensen

Schiøttz‐Christensen

Skovsgaard

et al. 2022

ActaO

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Background and purpose: Over the last decades, many countries have shown increased surgery rates for lumbar spinal stenosis (LSS), but little information is available from Denmark. We describe the development in diagnosis and surgery of LSS in Denmark between 2002 and 2018.Patients and methods: We collected diagnostic ICD10-codes and surgical procedure codes from private and public hospitals in Denmark from the Danish National Patient Register. Patients diagnosed with LSS and those with surgical procedure codes for decompression surgery with or without fusion were identified. Annual surgery rates were stratified by age, sex, and type of surgery.Results: During these 17 years, 132,138 patients diagnosed with LSS and 43,454 surgical procedures for LSS were identified. The number of surgical procedures increased by 144%, from 23 to 56 per 100,000 inhabitants. The proportion of patients diagnosed with LSS who received surgery was about 33%, which was almost stable over time. Decompression without fusion increased by 128% from 18 to 40 per 100,000 inhabitants and decompression with fusion increased by 199%, from 5 to 15 per 100,000.Interpretation: Both the prevalence of LSS diagnoses and LSS surgery rates more than doubled in Denmark between 2002 and 2018. However, the proportion of patients diagnosed with LSS who received surgery remained stable. Decompression surgery with fusion increased at a higher rate than decompression without fusion, although recent evidence suggests no advantage of decompression plus fusion over decompression alone.

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“…2,3 The treatment options range from non-surgical approaches such as analgesics, physiotherapy, and epidural corticosteroid injections to surgical methods. In the last few decades, the number of surgical procedures to treat DLSS has worldwide increased steadily [4][5][6][7] -in particular in patients older than 65 years of age 8 -despite debates on mid-to long-term improvement in pain or disability [9][10][11] and a potential higher economic burden of surgery. 4 Despite of an impressive number of published studies, 9,[11][12][13][14][15][16][17][18][19][20][21][22][23] the best treatment strategy for patients with DLSS is still a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

Long-term Results After Surgical or Nonsurgical Treatment in Patients With Degenerative Lumbar Spinal Stenosis

Burgstaller

Steurer

Gravestock

et al. 2020

Spine

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The aim of our study was to assess the course of patients over a period of three years undergoing surgical or non-surgical treatments for degenerative lumbar spinal stenoses (DLSS) based on data from the Lumbar Stenosis Outcome Study (LSOS), prospectively performed in eight hospitals. SUMMARY OF BACKGROUND DATA: The optimal treatment strategy for patients with DLSS is still debated. METHODS: The outcomes of patients with verified DLSS were quantified by Spinal Stenosis Measure (SSM) symptoms-and SSM function-scores, and EQ-5D-3L (quality of life) summary index (SI) over time (up to 36-month follow-up), and minimal clinically important difference (MCID) in SSM symptoms, SSM function, and EQ-5D-3L SI from baseline to 36-month follow-up. RESULTS: For this study, 601 patients met the inclusion criteria; 430 underwent surgery, 18 of them only after more than a year after enrolment, 171 received non-surgical treatment only. At baseline, patients in the surgical and nonsurgical groups had similar values for the SSM symptoms and SSM function scores, but patients in the surgical group suffered significantly more from buttocks pain and reported more worsening symptoms over the last three months before enrollment in the study. Surgically treated patients (except changers) performed significantly better in all clinical outcome measures (p < 0.001) with a plateau at 12-month follow-up staying constant until the follow-up ended. Further, two thirds of patients in the surgical group had a relevant improvement in function, symptoms, and quality of life, compared to only about half of those in terms of symptoms and even less in terms of function and quality of life with non-surgical treatment. CONCLUSIONS: Surgical treatment of DLSS results in more favorable clinical outcomes with a sustained effect over time, compared to non-surgical treatment. LEVEL OF EVIDENCE: 3

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The Rates of LSS Surgery in Norwegian Public Hospitals

Cited by 18 publications

References 39 publications

Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway

Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway

Surgery rates for lumbar spinal stenosis in Denmark between 2002 and 2018: a registry-based study of 43,454 patients

Long-term Results After Surgical or Nonsurgical Treatment in Patients With Degenerative Lumbar Spinal Stenosis

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