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Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
  1. Margreth Grotle1,2,
  2. Milada Cvancarova Småstuen3,
  3. Olaf Fjeld4,
  4. Lars Grøvle5,
  5. Jon Helgeland6,
  6. Kjersti Storheim7,8,
  7. Tore K Solberg9,10,
  8. John-Anker Zwart11,12
  1. 1 Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
  2. 2 Research and Communication Unit for Musculoskeletal Health, Oslo universitetssykehus Ulleval, Oslo, Norway
  3. 3 Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
  4. 4 Research and Communication Unit for Musculoskeletal Disorders, Oslo universitetssykehus Ulleval, Oslo, Norway
  5. 5 Department of Rheumatology, Hospital of Ostfold HF, Norway
  6. 6 Division of Health Services, Nasjonalt folkehelseinstitutt, Oslo, Norway
  7. 7 Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo, Norway
  8. 8 Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
  9. 9 Neurosurgery, University Hospital of North Norway, Tromsø, Norway
  10. 10 The Norwegian Registry for Spine Surgery, North Norway Health Authority, Tromsø, Norway
  11. 11 Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
  12. 12 Faculty of Medicine, University of Oslo, Oslo, Norway
  1. Correspondence to Professor Margreth Grotle; mgrotle{at}


Background Studies from different Western countries have reported a rapid increase in spinal surgery rates, an increase that exceeds by far the growing incidence rates of spinal disorders in the general population. There are few studies covering all lumbar spine surgery and no previous studies from Norway.

Objectives The purpose of this study was to investigate trends in all lumbar spine surgery in Norway over 15 years, including length of hospital stay, and rates of complications and reoperations.

Design A longitudinal observational study over 15 years using hospital patient administrative data and sociodemographic data from the National Registry in Norway.

Setting and participants Patients aged ≥18 years discharged from Norwegian public hospitals between 1999 and 2013.

Outcome measures Annual rates of simple (microsurgical discectomy, decompression) and complex surgical procedures (fusion, disc prosthesis) in the lumbar spine.

Results The rate of lumbar spine surgery increased by 54%, from 78 (95% CI (75 to 80)) to 120 (107 to 113) per 100 000, from 1999 to 2013. More men had simple surgery whereas more women had complex surgery. Among elderly people over 75 years, lumbar surgery increased by a factor of five during the 15-year period. The rates of complications were low, but increased from 0.7% in 1999 to 2.4% in 2013.

Conclusions There was a substantial increase in lumbar spine surgery in Norway from 1999 to 2013, similar to trends in other Western world countries. The rise in lumbar surgery among elderly people represents a significant workload and challenge for health services, given our aging population.

  • neurosurgery
  • orthopaedic and trauma surgery
  • epidemiology

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  • Contributors MG, JH and J-AZ designed the study. MG and MCS analysed the data. J-AZ, OF, LG, KS and TKS contributed in discussion of analyses and results presentation. MG wrote the manuscript with all authors contributing in reading, commenting and approving the final manuscript.

  • Funding This work was supported by the South-Eastern Norway Regional Health 3 Authority, grant number 2013030.

  • Competing interests None declared.

  • Ethics approval The study was approved by the Norwegian Data Inspectorate (2014/14413) and the 8 Norwegian Regional Ethics Committee (2013/1662, REC south-east D).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No data are available.

  • Patient consent for publication Not required.

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