The Korean Journal of Health Service Management (보건의료산업학회지)

Korea Society of Health Service Management (보건의료산업학회)
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The Effect of Timing of Primary Surgery on Outcomes of Lumbar Herniated Intervertebral Disc

요추 추간판탈출증 환자의 초기 수술시점이 진료결과에 미치는 영향

  • Choi, Bo-Ram (Department of Nursing, Kyungdong University) ;
  • Ji, Young-Geon (Department of Preventive Medicine, CHA University) ;
  • Shin, Dong-Ah (Department of Neurosurgery, Bundang CHA Medical Center) ;
  • Om, Young-Jin (Department of Preventive Medicine, CHA University) ;
  • Rhie, Dong-Mo (Department of Preventive Medicine, CHA University) ;
  • Kang, Hyung-Gon (Department of Preventive Medicine, CHA University)
  • 최보람 (경동대학교 간호학과) ;
  • 지영건 (차의과학대학교 예방의학교실) ;
  • 신동아 (분당차병원 신경외과) ;
  • 엄영진 (차의과학대학교 예방의학교실) ;
  • 이동모 (차의과학대학교 예방의학교실) ;
  • 강형곤 (차의과학대학교 예방의학교실)
  • Received : 2013.12.28
  • Accepted : 2014.02.07
  • Published : 2014.03.30
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Abstract

This study was conducted to investigate the effect of timing of surgery on outcomes of spine operated patients for lumbar herniated intervertebral disc. The research design was cohort study and based on the data of claims for the medical expenses of health insurance. 21,475 cases who had primary spine surgery between January 1, and December 31, 2003, observed to conservative treatment period in the past two years from preoperative primary diagnosis to timing of primary surgery. According to one and five year follow up monitoring, the probability of occurrence of reoperation was not statistically significant with preoperative duration of symptom. Also one year follow up, the probability of occurrence of complication, was not statistically significant with preoperative duration of symptom. But five year follow up, groups who had one to two month preoperative duration of symptom decreased complication rate than less than a month(95%CI:0.594-0.927). Thus, from the onset of symptoms of back pain before primary surgery with enough and adequate time observation is required. Also, medical consumers or providers to choose surgery in determining prudence is required.

Keywords

References

  1. CBS Nocut News(2011.11.20), The center of our bodies 'shaken spine'.
  2. S.I. Suk(2004), Spine Surgery(2nd ed.). Newest Medicine Company, p.191.
  3. S.K. Mirza, R.A. Deyo, P.J. Heagerty, J.A. Turner, L.A. Lee, R. Goodkin(2006), Towards Standardized Measurement of Adverse Events in Spine Surgery: Conceptual Model and Pilot Evaluation, Bio Med Central Musculoskelet Disorders, Vol.20(7);53(1-16).
  4. A. Hakkinen, I. Kiviranta, M.H. Neva, H. Kautiainen, J. Ylinen(2007), Reoperations after First Lumbar Disc Herniation Surgery; A Special Interest on Residives During a 5-year Follow-up, Bio Med Central Musculoskelet Disorders, Vol.8(2);1-6. https://doi.org/10.1186/1471-2474-8-1
  5. J.A. Rihn, A.S. Hilibrand, K. Radcliff, M. Kurd, J. Lurie, E. Blood, T.J. Albert, J.N. Weinstein(2011), Duration of Symptoms Resulting from Lumbar Disc Herniation: Effect on Treatment Outcomes: Analysis of the Spine Patient Outcomes Research Trial (SPORT), The Journal of Bone and Joint Surgery. American volume, Vol.93(20);1906-1914. https://doi.org/10.2106/JBJS.J.00878
  6. L.C. Ng, P. Sell(2004), Predictive Value of the Duration of Sciatica for Lumbar Discectomy: A Prospective Cohort Study, The Journal of Bone and Joint Surgery. British volume, Vol.86;546-549. https://doi.org/10.2106/00004623-200403000-00013
  7. Y.H. Lee(2009), Editorial: Characteristics of Korean Patients with RA: A Single Center Cohort Study, The Journal of the Korean Rheumatism Association, Vol.16(4);261-263. https://doi.org/10.4078/jkra.2009.16.4.261
  8. S.S. Bederman, H.J. Kreder, I. Weller, J.A. Finkelstein, M.H. Ford, A.J. Yee(2009), The Who, What and When of Surgery for the Degenerative Lumbar Spine: a Population-based Study of Surgeon Factors, Surgical Procedures, Recent Trends and Reoperation Rates, Canadian Journal of Surgery, Vol.52(4);283-290.
  9. Y. Nohara, H. Taneichi, K. Ueyama, N. Kawahara, K. Shiba, Y. Tokuhashi, T. Tani, S. Nakahara, T Iida(2004), Nationwide survey on complications of spine surgery in Japan. Journal of Orthopaedic Science, Vol.9;424-433. https://doi.org/10.1007/s00776-004-0802-7
  10. R. Akagi, Y. Aoki, Y. Ikeda, F. Nakajima, S. Ohtori, K. Takahashi, M. Yamagata(2010), Comparison of Early and Late Surgical Intervention for Lumbar Disc Herniation: is Earlier Better?, Journal of Orthopaedic Science, Vol.15(3);294-298. https://doi.org/10.1007/s00776-010-1457-1
  11. Y. Folman, S. Shabat, A. Catz, R. Gepstein(2008), Late Results of Surgery for Herniated Lumbar Disk as Related to Duration of Preoperative Symptoms and Type of Herniation, Surgical Neurology, Vol.70;398-401. https://doi.org/10.1016/j.surneu.2007.04.022
  12. J. Dvorak, M.H. Gauchat, L. Valach(1988), The Outcome of Surgery for Lumbar Disc Herniation: I. A 4-17 Years' Follow-up with Emphasis on Somatic Aspects, Spine, Vol.13(12);1418-22. https://doi.org/10.1097/00007632-198812000-00015
  13. P.M. Trief, W. Grant, B. Fredrickson(2000), A Prospective Study of Psychological Predictors of Lumbar Surgery Outcome, Spine, Vol.25(20);2616-2621. https://doi.org/10.1097/00007632-200010150-00012
  14. C. Fisher, V. Noonan, P. Bishop, M. Boyd, D. Fairholm, P. Wing, M. Dvorak(2004), Outcome Evaluation of the Operative Management of Lumbar Disc Herniation Causing Sciatica, Journal of Neurosurgery, Vol.100;317-324.
  15. Washington State Department of Labor and Industries(2002), Guidelines for lumbar fusion(arthrodesis). Olympia(WA): Washington State Department of Labor and Industries, 5 (http://pmmp.cnki.net/Resources/CDDPdf/evd%5Cbase%5CNational%20Guideline%20Clearinghouse%5C%E4%B8%B4%E5%BA%8A%E5%AE%9E%E8%B7%B5%E6%8C%87%E5%8D%97%5C1425.pdf)
  16. H. Nakagawa, M. Kamimura, K. Takahara, H. Hashidate, A. Kawaguchi(2007), Uchiyama S, Miyasaka T. Optimal Duration of Conservative Treatment for Lumbar Disc Herniation Depending on the Type of Herniation, Journal of Neuroscience, Vol.14(2);104-109.
  17. J.N. Weinstein, T.D. Tosteson, J.D. Lurie, A.N. Tosteson, B. Hanscom, J.S. Skinner, W.A. Abdu, A.S. Hilibrand, S.D. Boden, R.A. Deyo(2006), Surgical vs Nonoperative Treatment for Lumbar Disk Herniation: The Spine Patient Outcomes Research Trial(SPORT): A Randomized Trial, Journal of the American Medical Association, Vol.296(20);2441-2450. https://doi.org/10.1001/jama.296.20.2441
  18. O.P. Nygaard, B. Romner, J.H. Trumpy(1994), Duration of Symptoms as a Predictor of Outcome After Lumbar Disc Surgery, Acta Neurochirurgica(Wien), Vol.128(1-4);53-56. https://doi.org/10.1007/BF01400653
  19. A. Nachemson(1969), Intradiscal Measurements of pH in Patients with Lumbar Rhizopathies, Acta Orthopaedica Scandinavica, Vol.40(1);23-42. https://doi.org/10.3109/17453676908989482
  20. B.I. Martin, S.K. Mirza, B.A. Comstock, D.T. Gray, W. Kreuter, R.A. Deyo(2007), Reoperation Rates Following Lumbar Spine Surgery and the Influence of Spinal Fusion Procedures, Spine, Vol.32(3);382-387 https://doi.org/10.1097/01.brs.0000254104.55716.46
  21. A.D. Malter, B. McNeney, J.D. Loeser, R.A. Deyo(1998), 5-year Reoperation Rates After Different Types of Lumbar Spine Surgery, Spine, Vol.23(7);814-820. https://doi.org/10.1097/00007632-199804010-00015
  22. M.J. Lee, J. Hacquebord, A. Varshney, A.M. Cizik, R.J. Bransford, C. Bellabarba, M.A. Konodi, J. Chapman(2011), Risk Factors for Medical Complication after Lumbar Spine Surgery: A Multivariate Analysis of 767 Patients, Spine, Vol.36(21);1801-1806. https://doi.org/10.1097/BRS.0b013e318219d28d
  23. R.A. Deyo, S.K. Mirza(2006), Trends and Variations in the Use of Spine Surgery, Clinical Orthopaedics and Related Research, Vol.443;139-146. https://doi.org/10.1097/01.blo.0000198726.62514.75
  24. S.K. Bae, H.K. Lee, T.J. Y, S.C. Jeong, J.H. Ryu, O.S Park(2013), A Study on the Effect of a Mission Hospital's Social Services Image Factors on Hospital Satisfaction of Patients : A Case of the K Hospital. The Korean Journal of Health Service Management, Vol.7(4);179-190. https://doi.org/10.12811/kshsm.2013.7.4.179
  25. J.K. Suh, S.K. Jang(2013), The Effect of Service Qualities with University Hospitals in Daejeon on their Overall Service Satisfaction, The Korean ournal of Health Service Management, Vol.7(4);96-103. https://doi.org/10.12811/kshsm.2013.7.4.093