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

Abstract

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.

Risk Factors of Intervertebral Disc Pathology—A Point of View Formerly and Today—A Review

“…These results show that the studies carried out by Young-Ki et al [ 76 ] and Jong-myung et al [ 78 ] had a similar frequency distribution in terms of age groups. Tabesh [ 77 ] obtained another crude incidence of lumbar disc herniation.…”

“…Another study carried out by Jong-myung et al [ 78 ] that was based on a national database in the Republic of Korea (ROK) from January 2008 to December 2016. The number of patients with diagnosed disc herniation increased from 2008 to 2012, and then fell.…”

“…In 2008, there were higher numbers of lumbar disc herniation in female patients than in male patients in their 30s, and 1.6 times higher than patients in their 60s. In 2016, the crude incidence was also higher in female patients than male patients in the 40s group, and 1.5 times higher in the 60s group [ 78 ].…”

A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

“…Hence, the medical community has examined different aspects of LDH and lumbar discectomies, the primary surgical treatment for LDH 8) . Epidemiologic trends including incidence, demographic factors and different surgical approaches have been delved into but have shown relatively small changes during the last decade 9) . Surgical results, infection rates and recurrence rates are also commonly studied 2,16,18) .…”

Association between pain and gait instability in patients with lumbar disc herniation

“… 1 LDH is the most common cause of sciatica, affecting 796.1 per 100 000 person-years in the Republic of Korea. 2 Lumbar and radiating leg pain are the main symptoms of LDH and these affect the patient’s activities of daily living and quality of life. 3 …”