title: Low back pain hospitalization. Recent United States trends and regional variations.
abstract: METHODS
  This study describes recent United States trends and regional variations in the management of low back pain.
  
  
  OBJECTIVE
  The authors investigated recent temporal trends and compared practices in different geographic regions.
  
  
  BACKGROUND
  Controversy exists concerning the appropriate medical and surgical management of patients with low back pain.
  
  
  METHODS
  National Hospital Discharge Survey data from 1979 through 1990 were analyzed. Case selection was based on previously developed algorithms intended to exclude nonmechanical causes of back pain.
  
  
  RESULTS
  Over the period of study, nonsurgical hospitalizations for low back pain decreased dramatically. In contrast, low back operation rates, particularly for fusion surgery, increased substantially. In recent years, surgery and hospitalization rates were highest in the South and lowest in the West.
  
  
  CONCLUSIONS
  Rapidly increasing surgical rates and wide geographic variations suggest the need for a more consistent approach to back problems.
authors.affiliation: Department of Health Services, University of Washington, Seattle.
authors.forename: V M
authors.initials: VM
authors.lastname: Taylor
authors.forename: R A
authors.initials: RA
authors.lastname: Deyo
authors.forename: D C
authors.initials: DC
authors.lastname: Cherkin
authors.forename: W
authors.initials: W
authors.lastname: Kreuter
mesh_terms: D000465:Algorithms; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D008297:Male; D009192:Myelography / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D013123:Spinal Fusion / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology