Abstract

Identifying the prevalence of degenerative spinal pathologies and relevant demographic risk factors is important for understanding spine injury risk, prevention, treatment, and outcome, and for distinguishing acute injuries from degenerative pathologies. Prevalence data in the literature are often based on small-scale studies focused on a single type of pathology. This study evaluates the prevalence of diagnosis of selected degenerative spinal pathology diagnoses using Medicare insurance claim data in the context of published smaller-scale studies. In addition, the data are used to evaluate whether the prevalence is affected by age, sex, diagnosed obesity, and the use of medical imaging. The Medicare Claims 5% Limited Data Set was queried to identify diagnoses of degenerative spinal pathologies. Unique patient diagnoses per year were further evaluated as a function of age, gender, and obesity diagnosis. Participants were also stratified by coding for radiological imaging accompanying each diagnosis. The overall prevalence of diagnosed spinal degenerative disease was 27.3% and increased with age. The prevalence of diagnosed disc disease was 2.7 times greater in those with radiology. The results demonstrate that degenerative findings in the spine are common, and, since asymptomatic individuals may not receive a diagnosis of degenerative conditions, this analysis likely underestimates the general prevalence of these conditions.

Highlights

  • Identifying the prevalence of degenerative spinal pathologies and relevant demographic risk factors is important for understanding spine injury risk, prevention, treatment, and outcome, and for distinguishing acute injuries from degenerative pathologies

  • Types of spinal degenerative pathologies examined in this study include stenosis, spine curvatures, diffuse idiopathic skeletal hyperostosis (DISH), spondylitis, osteoporosis, and disc degeneration

  • Diagnostic codes were used to identify the prevalence of degenerative spinal pathologies and differences based on age, sex, and obesity from Medicare data

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Summary

Introduction

Identifying the prevalence of degenerative spinal pathologies and relevant demographic risk factors is important for understanding spine injury risk, prevention, treatment, and outcome, and for distinguishing acute injuries from degenerative pathologies. This study evaluates the prevalence of diagnosis of selected degenerative spinal pathology diagnoses using Medicare insurance claim data in the context of published smaller-scale studies. It is relevant to understand the prevalence of degenerative spine pathologies Spine degeneration affects both the mechanical properties and anatomic morphology of the vertebrae, discs, and surrounding soft tissues. Types of spinal degenerative pathologies examined in this study include stenosis, spine curvatures (kyphosis, lordosis, and scoliosis), diffuse idiopathic skeletal hyperostosis (DISH), spondylitis, osteoporosis, and disc degeneration. The prevalence of these pathologies was further evaluated based on age, sex, and obesity. A diagnosis of lordosis typically refers to excessive concave curvature of the lumbar spine in the sagittal plane

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