Dragan Zac, George Adam R, Campbell Ryan J, Gray Randolph, Sivakumar Brahman Shankar, Symes Michael
Faculty of Medicine and Health, The University of Sydney, Sydney Medical School, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, New South Wales, Australia.
J Craniovertebr Junction Spine. 2024 Jul-Sep;15(3):338-342. doi: 10.4103/jcvjs.jcvjs_119_24. Epub 2024 Sep 12.
Favorable short- and long-term outcomes have been reported for lumbar intervertebral total disc replacement (L-TDR). However, there is little evidence regarding the uptake of L-TDR in practice. The objective of this study was to analyze Australian-based population trends in L-TDR over the past 5 years.
The 5-year incidence of L-TDR from 2019 to 2023 in adult patients was analyzed using the Medicare Benefits Schedule (MBS) database. Data were stratified by sex and year, with an offset term introduced using population data from the Australian Bureau of Statistics to account for population changes over the study period.
A total of 1558 L-TDRs were completed in Australia under the MBS in the 5 years of interest. The 5-year annual mean case volume was 311.6 cases per annum. A downtrend and plateau in the rate of L-TDR has been seen from 2021 onward. The distribution of L-TDR across ages showed a significantly higher concentration in the 35-44 and 45-54 age groups (P < 0.05). More operations were performed in males (n = 876, 56.2%) than females (n = 682, 43.8%).
The uptake of L-TDR has declined throughout the 5-year study period in Australia. Despite modest use currently, the future of L-TDR will rely on more robust long-term outcome data.
已有报道称腰椎全椎间盘置换术（L-TDR）具有良好的短期和长期疗效。然而，关于L-TDR在实际应用中的采用情况，几乎没有相关证据。本研究的目的是分析过去5年澳大利亚L-TDR的人群趋势。
使用医疗保险福利计划（MBS）数据库分析2019年至2023年成年患者L-TDR的5年发病率。数据按性别和年份分层，并引入澳大利亚统计局的人口数据作为偏移项，以考虑研究期间的人口变化。
在感兴趣的5年中，澳大利亚共有1558例L-TDR在MBS下完成。5年的年平均病例数为每年311.6例。自2021年起，L-TDR的发生率呈下降趋势并趋于平稳。L-TDR在各年龄段的分布显示，35-44岁和45-54岁年龄组的集中度显著更高（P < 0.05）。男性进行的手术（n = 876，56.2%）比女性（n = 682，43.8%）更多。
在澳大利亚的5年研究期内，L-TDR的采用率有所下降。尽管目前使用量不大，但L-TDR的未来将依赖于更可靠的长期疗效数据。
