Naidu Ramana K, Tran Oth V, Schatman Michael E
Pain Management, Marin Health Medical Center, Greenbrae, CA, USA.
Health Economics & Outcomes Research, Boston Scientific, Marlborough, MA, USA.
J Pain Res. 2024 Jun 4;17:1979-1987. doi: 10.2147/JPR.S454887. eCollection 2024.
Evidence regarding the frequency and timing of treatment for lumbar spinal stenosis (LSS) fails to offer clear consensus. We describe the LSS care journey from initial diagnosis to first surgical intervention.
Using Medicare claims database from 2009 through 2020, we identified patients who were diagnosed with LSS. The use and timing of conservative and surgical treatments during the entire follow-up from the initial diagnosis were reported.
Of the 143,849 patients identified, 68% received conservative care within 8.4 months and 25.3% received a surgical or minimally invasive intervention over 5.7 years following initial diagnosis, with 12.6% undergoing open decompression alone, 10.2% undergoing open decompression with fusion, and 5.1% undergoing fusion surgery alone. Fewer than 1% were provided with interspinous spacers or a percutaneous image-guided lumbar decompression.
Approximately three-quarters of patients in the study received no surgical or non-invasive interventions for approximately six years following diagnosis with LSS.
关于腰椎管狭窄症（LSS）治疗的频率和时机的证据未能达成明确共识。我们描述了从初次诊断到首次手术干预的LSS治疗过程。
利用2009年至2020年的医疗保险索赔数据库，我们确定了被诊断为LSS的患者。报告了从初次诊断开始的整个随访期间保守治疗和手术治疗的使用情况及时机。
在确定的143,849名患者中，68%在8.4个月内接受了保守治疗，25.3%在初次诊断后的5.7年内接受了手术或微创干预，其中12.6%仅接受了开放减压，10.2%接受了开放减压融合术，5.1%仅接受了融合手术。不到1%的患者接受了棘突间撑开器或经皮影像引导下腰椎减压术。
在该研究中，约四分之三的患者在被诊断为LSS后的大约六年内未接受手术或非侵入性干预。
