title: Prevalence of diagnosis and direct treatment costs of back disorders in 644,773 children and youths in Germany.
abstract: BACKGROUND
  Many authors have reported about the high prevalence rates of self-reported back pain in children. Nevertheless, little is known about the diagnosis of back disorders--regardless of whether the diagnosis is associated with back pain or not. Therefore, the aim of this study was to analyse the prevalence rates and costs of diagnosis of back disorders in childhood and youth.
  
  
  METHODS
  We conducted a secondary data analysis of a large, population based German data set (2,300,980 insurants of statutory health insurance funds) which allowed for identification of prevalence rates of diagnoses of back disorders in children (age group 0-14 years) and youths (age group 15-24 years) using three digit ICD-10 codes for dorsopathies (M40-M54: kyphosis and lordosis; scoliosis; spinal osteochondrosis; other deforming dorsopathies; ankylosing spondylitis; other inflammatory spondylopathies; spondylosis; other spondylopathies; spondylopathies in diseases classified elsewhere; cervical disc disorders; other intervertebral disc disorders; other dorsopathies, not elsewhere classified; dorsalgia). Direct treatment costs were calculated based on the real incurred costs for cases with a singular diagnosis of a back disorder. Wherever possible, the results of the random sample were extrapolated to all insurants of statutory health insurance funds (i. e., about 90% of the German population).
  
  
  RESULTS
  We found prevalence rates for the diagnosis of back disorders to range between 0.01 - 12.5%. "Scoliosis" (M41) and "dorsalgia" (M54) were the most frequent diagnoses in both age groups. Based on these results, it was calculated that in 2002 alone, approximately 1.4 million children/youths in Germany were diagnosed with "dorsalgia" (M54), and that the direct costs for back disorders in childhood and youth accounted for at least 100 million Euros.
  
  
  CONCLUSIONS
  Instead of focusing on the individual, and self-reported disorder or disability, this analysis allowed for the detailed evaluation of medical experts' opinion on back disorders in childhood and youth and for a more objective or public health oriented insight in the topic of diagnosis of back pain and other back disorders. However, due to the methodological limitations by using ICD-10 coding, standardized random validity checks of population based data sets should be mandatory.
authors.affiliation: Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany. eochsmann@ukaachen.de
authors.forename: Elke B
authors.initials: EB
authors.lastname: Ochsmann
authors.forename: Carlos L
authors.initials: CL
authors.lastname: Escobar Pinzón
authors.forename: Stephan
authors.initials: S
authors.lastname: Letzel
authors.forename: Thomas
authors.initials: T
authors.lastname: Kraus
authors.forename: Martina
authors.initials: M
authors.lastname: Michaelis
authors.forename: Eva
authors.initials: E
authors.lastname: Muenster
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D001416:Back Pain / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D013122:Spinal Diseases / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D055815:Young Adult
references.citation: Ann Fam Med. 2009 Jul-Aug;7(4):352-6
references.pmid: 19597173
references.citation: Int J Med Inform. 2008 Jan;77(1):50-7
references.pmid: 17185030
references.citation: Acta Paediatr. 2004 Feb;93(2):258-63
references.pmid: 15046285
references.citation: Spine (Phila Pa 1976). 2007 Nov 1;32(23):2630-7
references.pmid: 17978666
references.citation: Gesundheitswesen. 2009 Dec;71(12):823-31
references.pmid: 19387933
references.citation: Scand J Prim Health Care. 2009;27(3):131-6
references.pmid: 19565412
references.citation: Eur Spine J. 2005 May;14(4):331-6
references.pmid: 15940479
references.citation: BMC Musculoskelet Disord. 2009 Jun 29;10:77
references.pmid: 19563667
references.citation: Spine (Phila Pa 1976). 1997 May 15;22(10):1132-6
references.pmid: 9160472
references.citation: Acta Paediatr. 1992 Dec;81(12):1035-9
references.pmid: 1290849
references.citation: Scand J Rehabil Med. 1988;20(4):175-9
references.pmid: 2976526
references.citation: Am J Public Health. 1992 Apr;82(4):606-8
references.pmid: 1532116
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008 Oct;51(10):1118-26
references.pmid: 18985405
references.citation: Arch Dis Child. 2005 Mar;90(3):312-6
references.pmid: 15723927
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007 May-Jun;50(5-6):686-700
references.pmid: 17514453
references.citation: Pain. 2002 May;97(1-2):87-92
references.pmid: 12031782
references.citation: Eur Spine J. 2008 Nov;17(11):1441-7
references.pmid: 18830637
references.citation: Pediatrics. 2005 Feb;115(2):e152-62
references.pmid: 15687423
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007 May-Jun;50(5-6):711-7
references.pmid: 17514455
references.citation: Biometrics. 1977 Jun;33(2):363-74
references.pmid: 884196
references.citation: Annu Rev Public Health. 1987;8:51-74
references.pmid: 3555530
references.citation: Disabil Rehabil. 1997 Dec;19(12):505-12
references.pmid: 9442988
references.citation: Curr Opin Pediatr. 2009 Feb;21(1):55-64
references.pmid: 19242241
references.citation: Eur Spine J. 1999;8(6):439-43
references.pmid: 10664300
references.citation: Rev Rhum Engl Ed. 1999 Jul-Sep;66(7-9):381-8
references.pmid: 10526378