Most elderly health insurance patients in Japan undergo non-surgical treatment for spinal stenosis



A large Japanese study has found that a significant number of spinal stenosis patients using health insurance claims are elderly people (>80 years), with most receiving non-surgical treatment. The research was published in Spine.

Lead author Izumi Kuboyama, The University of Tokyo, Tokyo, Japan, and colleagues decided to conduct this population-based retrospective descriptive study, as “few reports have documented the prevalence of spinal stenosis, and no report has described the therapeutic profile for spinal stenosis in a population base”.

Kuboyama et al studied the claims data of National Health Insurance and Late-stage Elderly Health Insurance in a Japanese prefecture from April 2010 to March 2011. Patients were considered to have to have spinal stenosis if their claims included at least one diagnosis coded as spinal stenosis for at least one month during the study period. Disease criteria were based on the tenth version of the International Classification of Diseases. The number and the therapeutic profile of the patients with spinal stenosis were then described by age and sex.

The authors identified 52,889 patients with spinal stenosis—76 per 100,000 beneficiaries—and those for the subgroups of age ≥ 65 years, ≥ 75 years, and ≥ 85 years were 128, 155, and 152, respectively. The number of patients per 1,000 beneficiaries showed unimodal distribution, and the peak for males was 191 for ages 95–99 years and that for females was 160 for ages 80–84 years. Analgesics, prostaglandin E1, or both were prescribed to 40%, 2%, or 20% of patients with spinal stenosis, respectively. Physical therapy, nerve blocks, and surgery were performed for 19%, 8%, and 0.4% of the patients, respectively. Approximately 33% of patients did not receive any treatment.

Reflecting on their results, Kuboyama and colleagues note that the use of health insurance claims data “could be a useful source of surveillance for such common diseases as spinal stenosis”.