000			04518nam a22005537a 4500
008			170428s20172017 xxu||||| |||| 00| 0 eng d
022			_a0362-2436
040			_aOvid MEDLINE(R)
099			_a28207664
245			_aDescriptive Analysis of Spinal Neuroaxial Injections, Surgical Interventions, and Physical Therapy Utilization for Degenerative Lumbar Spondylolisthesis Within Medicare Beneficiaries from 2000 to 2011.
251			_aSpine. 42(4):240-246, 2017 02 15
252			_aSpine. 42(4):240-246, 2017 02 15
253			_aSpine
260			_c2017
260			_fFY2017
266			_d2017-05-06
501			_aAvailable online from MWHC library: 1996 - present, Available in print through MWHC library: 1999 - February 2003
520			_aCONCLUSION: Interventional techniques and physical therapy are frequently used treatment modalities for symptomatic degenerative spondylolisthesis. Understanding utilization of these techniques is important to determine relative clinical efficacies and to optimize future health care expenditures.
520			_aLEVEL OF EVIDENCE: N/A.
520			_aMETHODS: This study utilized the 5% national sample of Medicare carrier claims from 2000 through 2011. A cohort of beneficiaries with a new International Classification of Diseases 9th edition (ICD-9) diagnosis code for degenerative lumbar spondylolisthesis was identified. Current procedural terminology codes were used to identify the number of procedures performed each year by specialty on this cohort.
520			_aOBJECTIVE: The aim of this study was to determine the utilization of various treatment modalities in the management of degenerative spondylolisthesis within Medicare beneficiaries.
520			_aRESULTS: A total of 95,647 individuals were included in the analysis. Average age at the time of initial diagnosis was 72.8 +/- 9.8 years. Within this study cohort, spondylolisthesis was more prevalent in females (69%) than males and in Caucasians (88%) than other racial demographics. Over 50% of beneficiaries underwent at least one injection, approximately one-third (37%) participated in physical therapy, one in five (21%) underwent spinal surgery, and one-third (36%) did not utilize any of these interventions. Greater than half of all procedures (124,280/216,088) occurred within 2 years of diagnosis. The ratio of focal interventions (transforaminal and facet interventions) to less selective (interlaminar) procedures was greater for the specialty of Physical Medicine and Rehabilitation than for the specialties of Anesthesiology, Interventional Radiology, Neurosurgery, and Orthopedic Surgery. The majority of physical therapy was dedicated to passive treatment modalities and range of motion exercises rather than active strengthening modalities within this cohort.
520			_aSTUDY DESIGN: A retrospective, observational study.
520			_aSUMMARY OF BACKGROUND DATA: Degenerative lumbar spondylolisthesis is a condition often identified in symptomatic low back pain. A variety of treatment algorithms including physical therapy and interventional techniques can be used to manage clinically significant degenerative spondylolisthesis.
546			_aEnglish
650			_a*Low Back Pain/th [Therapy]
650			_a*Lumbar Vertebrae/su [Surgery]
650			_a*Lumbosacral Region/su [Surgery]
650			_a*Medicare
650			_a*Physical Therapy Modalities
650			_a*Spondylolisthesis/su [Surgery]
650			_aAged
650			_aAged, 80 and over
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aPhysical Therapy Modalities/ec [Economics]
650			_aRetrospective Studies
650			_aSpinal Fusion/mt [Methods]
650			_aUnited States
651			_aMedStar National Rehabilitation Network
657			_aJournal Article
700			_aSclafani, Joseph A
790			_aAkuthota V, Chan L, Constantin A, Ho PS, Sclafani JA
856			_uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-201702150-00012&LSLINK=80&D=ovft _zhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-201702150-00012&LSLINK=80&D=ovft _zhttps://dx.doi.org/10.1097/BRS.0000000000001724
856			_uhttps://dx.doi.org/10.1097/BRS.0000000000001724 _zhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-201702150-00012&LSLINK=80&D=ovft _zhttps://dx.doi.org/10.1097/BRS.0000000000001724
942			_cART _dArticle
999			_c2703 _d2703