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Relationship Between Percutaneous Procedures and Lumbar Infections Based on Data From The National Health Insurance Review & Assessment Service of Korea

Moon, Young-Jae MD; Kim, Do-Yeon MD; Song, Kyung-Jin MD; Kim, Yong Jin MD; Lee, Kwang-Bok MD

doi: 10.1097/BSD.0000000000000095

Study Design: A study from the National health insurance database.

Objective: To investigate the relationship between percutaneous procedures or open surgeries and spinal infections using the 5-year large unit national dataset.

Summary of Background Data: There is no nation-based research data on the relationship between percutaneous procedures and spinal infections in Korea.

Materials and Methods: This study used disease codes (ICD-10: International Classification of Disease) and operation fee codes (national medical insurance) registered in the National Health Insurance Review & Assessment Service for the 5 years from 2007 to 2011. Using the above disease codes, the number of each percutaneous procedure, open surgery, and the number of lumbar infections were investigated by the regional and national units, and the relationship between procedures or open surgeries and lumbar infection was compared statistically.

Results: Lumbar infection showed a gradual growing annual trend, with a 3-fold increase in 2011 compared with 2007. Percutaneous procedures (nerve blocks) increased by approximately 2.6 times over 4 years. Kyphoplasty tended to decrease each year. Open surgeries (posterior fusion, discectomy, and laminectomy) were at a similar level each year. Lumbar infection and percutaneous procedures were positively correlated, and a negative correlation was observed between kyphoplasty and open surgeries. The incidence of lumbar infection was higher in large cities than provinces and increased 2–3 times in 2011 compared with 2007 in all regions.

Conclusions: There was no significant difference in the number of open surgeries for the 5-year study, but the number of percutaneous procedures (nerve blocks) increased each year, showing an approximate 4-fold increase in 4 years. Lumbar infection showed a positive correlation with percutaneous procedures, and kyphoplasty and open surgeries were negatively correlated. Therefore, as selective nerve block procedure is also considered an important factor affecting the growing trend of lumbar infections, unnecessary procedures should be avoided to reduce the absolute number of infections.

*Research Institute of Clinical Medicine of Chonbuk National University

Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea

The authors did not receive fund from any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI).

The authors declare no conflict of interest.

Reprints: Kwang-Bok Lee, MD, Department of Orthopedic Surgery, Chonbuk National University Medical School and Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712, Korea (e-mail:

Received December 17, 2013

Accepted March 14, 2014

© 2016 by Lippincott Williams & Wilkins, Inc.