title: Relationship Between Percutaneous Procedures and Lumbar Infections Based on Data From The National Health Insurance Review & Assessment Service of Korea.
abstract: METHODS
  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.
  
  
  BACKGROUND
  There is no nation-based research data on the relationship between percutaneous procedures and spinal infections in Korea.
  
  
  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.
authors.affiliation: *Research Institute of Clinical Medicine of Chonbuk National University†Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Moon
authors.forename: Do-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Kyung-Jin
authors.initials: KJ
authors.lastname: Song
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Kwang-Bok
authors.initials: KB
authors.lastname: Lee
mesh_terms: D016208:Databases, Factual; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D017587:Diskectomy, Percutaneous / Q000592:standards / Q000706:statistics & numerical data*; D004724:Endoscopy; D006801:Humans; D007348:Insurance, Health; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D056910:Republic of Korea; D013530:Surgical Wound Infection