South Korean degenerative spondylolisthesis patients had surgical treatment at earlier age than Japanese, American, and European patients: a published literature observation

TL;DR

This study reviews international surgical data for degenerative spondylolisthesis, revealing South Korean patients undergo surgery at a younger age than Japanese, American, and European patients, indicating possible differences in treatment practices.

Contribution

It provides a comparative analysis of the age at surgery for degenerative spondylolisthesis across different countries based on literature data, highlighting regional practice variations.

Findings

South Korean patients undergo surgery at a median age of 60 years.

Japanese and European patients have a median age of 66 years at surgery.

American patients have a median age of 65 years.

Abstract

Physical therapy is the first line of treatment for adults with symptoms from degenerative spondylolisthesis. Surgical management is offered when nonoperative options have not adequately relieved symptoms. We performed PubMed literature search with the word 'spondylolisthesis', and updated till September 18, 2016. We selected original research data involving surgical treatment of degenerative spondylolisthesis, and in total there were n articles, including data reported from Japan (n=37 series), South Korea (n=11 series), mainland China (n=5 series), and ROC (Taiwan, n=3 series), America (n=20 series), Europe (n=23 series). The mean age of each study were extracted and used a single entry. We tried our best to filter out double/multiple reported data. Our results showed the median age of degenerative spondylolisthesis patients underwent surgical treatment was 66 years in Japan, 60 years in South Korea, 59 years in mainland China, 59 years in ROC (Taiwan), 65 years in USA, and 66 years in Europe. This study indicates Japan and South Korea may have different surgical practice pattern. It will be of interested to investigate whether more proportion of degenerative spondylolisthesis patients have been treated surgically in South Korea than in Japan. The cost-effectiveness of different approaches may warrant further analysis by professional spine surgeons.