挪威公立医院腰椎间盘突出症手术率：1999 年至 2013 年增长三倍。
The Rates of LSS Surgery in Norwegian Public Hospitals: A Threefold Increase From 1999 to 2013.
机构信息
Department of Rheumatology, Østfold Hospital Trust, Grålum, Norway.
Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.
出版信息
Spine (Phila Pa 1976). 2019 Mar 15;44(6):E372-E378. doi: 10.1097/BRS.0000000000002858.
STUDY DESIGN
Retrospective administrative database study.
OBJECTIVE
To assess temporal and regional trends, and length of hospital stay, in lumbar spinal stenosis (LSS) surgery in Norwegian public hospitals from 1999 to 2013.
SUMMARY OF BACKGROUND DATA
Studies from several countries have reported increasing rates of LSS surgery over the last decades. No such data have been presented from Norway.
METHODS
A database consisting of discharges from all Norwegian public hospitals was established. Inclusion criteria were discharges including a surgical procedure of lumbar spinal decompression and/or fusion in combination with an International Statistical Classification of Diseases and Related Health Problems, 10th Revision diagnosis of Spinal Stenosis (M48.0) or Other Spondylosis with Radiculopathy (M47.2), and a patient age of 18 years or older. Discharges with diagnoses indicating deformity, that is, spondylolisthesis or scoliosis were not included.
RESULTS
During the 15-year period, 19,543 discharges were identified. The annual rate of decompressions increased from 10.7 to 36.2 and fusions increased from 2.5 to 4.4 per 100,000 people of the general Norwegian population. The proportion of fusion surgery decreased from 19.3% to 10.9%. Among individuals older than 65 years, the annual rate of surgery per 10,000, including both decompressions and fusions, more than quadrupled from 40.2 to 170.3. The regional variation was modest, differing with a factor of 1.4 between the region with the highest and the lowest surgical rates. The mean length of hospital stay decreased from 11.0 (standard deviation 8.0) days in 1999 to 5.0 (4.6) days in 2013, but patients who received fusion surgery stayed on average 3.6 days longer than those who received decompression only.
CONCLUSION
The rate of LSS surgery more than tripled in Norway from 1999 to 2013. The mean length of hospital stay was reduced from 11 to 5 days.
LEVEL OF EVIDENCE
N/A.
研究设计
回顾性行政数据库研究。
目的
评估 1999 年至 2013 年期间挪威公立医院腰椎管狭窄症（LSS）手术的时间和地域趋势，以及住院时间。
背景数据概要
来自多个国家的研究报告称，过去几十年 LSS 手术的比例一直在增加。但挪威尚未有此类数据公布。
方法
建立了一个由所有挪威公立医院出院记录组成的数据库。纳入标准为出院记录中包含腰椎减压和/或融合手术，同时伴有国际疾病分类第十版（ICD-10）诊断为椎管狭窄症（M48.0）或伴有神经根病的其他脊柱关节病（M47.2），且患者年龄在 18 岁或以上。不包括有畸形诊断的出院记录，即脊柱滑脱或脊柱侧凸。
结果
在 15 年期间，共确定了 19543 例出院记录。减压手术的年发病率从 10.7 例增加到 36.2 例，融合手术从 2.5 例增加到 4.4 例/每 10 万挪威人口。融合手术的比例从 19.3%下降到 10.9%。在 65 岁以上的人群中，包括减压和融合在内的手术年发病率每 10000 例增加了四倍多，从 40.2 例增加到 170.3 例。地域差异较小，手术率最高和最低的地区之间差异系数为 1.4。住院时间的平均值从 1999 年的 11.0 天（标准差 8.0 天）下降到 2013 年的 5.0 天（4.6 天），但接受融合手术的患者平均比接受单纯减压手术的患者多住院 3.6 天。
结论
1999 年至 2013 年期间，挪威 LSS 手术的比例增加了两倍多。住院时间从 11 天缩短至 5 天。
证据水平
N/A。
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