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

Background Studies 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...

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Main Authors: John-Anker Zwart, Jon Helgeland, Milada Cvancarova Småstuen, Kjersti Storheim, Margreth Grotle, Olaf Fjeld, Lars Grøvle, Tore K Solberg
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e028743.full
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author John-Anker Zwart
Jon Helgeland
Milada Cvancarova Småstuen
Kjersti Storheim
Margreth Grotle
Olaf Fjeld
Lars Grøvle
Tore K Solberg
author_facet John-Anker Zwart
Jon Helgeland
Milada Cvancarova Småstuen
Kjersti Storheim
Margreth Grotle
Olaf Fjeld
Lars Grøvle
Tore K Solberg
author_sort John-Anker Zwart
collection DOAJ
description Background Studies 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.Objectives The 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.Design A longitudinal observational study over 15 years using hospital patient administrative data and sociodemographic data from the National Registry in Norway.Setting and participants Patients aged ≥18 years discharged from Norwegian public hospitals between 1999 and 2013.Outcome measures Annual rates of simple (microsurgical discectomy, decompression) and complex surgical procedures (fusion, disc prosthesis) in the lumbar spine.Results The 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.Conclusions There 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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spelling doaj-art-53b6ec1372e044c0ad10f53b80fa9e0d2025-08-20T01:53:36ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-028743Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from NorwayJohn-Anker Zwart0Jon Helgeland1Milada Cvancarova Småstuen2Kjersti Storheim3Margreth Grotle4Olaf Fjeld5Lars Grøvle6Tore K Solberg7Research and Communication Unit for Musculoskeletal Health(FORMI), Oslo University Hospital HF, Oslo, NorwayCluster for Health Services Research, Norwegian Institute of Public Health, Oslo, NorwayFaculty of Health Sciences, Oslo Metropolitan University, Oslo, NorwayFaculty of Medicine, Norwegian University of Science and Technology, Trondheim, Høgskoleringen 1, 7491 Trondheim (MR), FORMI, Oslo University Hospital, Kirkevn 166, 0407 OsloFaculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway4 Research and Communication Unit for Musculoskeletal Disorders, Oslo universitetssykehus Ulleval, Oslo, Norwayphysician9 Neurosurgery, University Hospital of North Norway, Tromsø, NorwayBackground Studies 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.Objectives The 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.Design A longitudinal observational study over 15 years using hospital patient administrative data and sociodemographic data from the National Registry in Norway.Setting and participants Patients aged ≥18 years discharged from Norwegian public hospitals between 1999 and 2013.Outcome measures Annual rates of simple (microsurgical discectomy, decompression) and complex surgical procedures (fusion, disc prosthesis) in the lumbar spine.Results The 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.Conclusions There 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.https://bmjopen.bmj.com/content/9/8/e028743.full
spellingShingle John-Anker Zwart
Jon Helgeland
Milada Cvancarova Småstuen
Kjersti Storheim
Margreth Grotle
Olaf Fjeld
Lars Grøvle
Tore K Solberg
Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
BMJ Open
title Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
title_full Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
title_fullStr Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
title_full_unstemmed Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
title_short Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
title_sort lumbar spine surgery across 15 years trends complications and reoperations in a longitudinal observational study from norway
url https://bmjopen.bmj.com/content/9/8/e028743.full
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