The Relative Impact of Lumbar Spondylosis on Quality of Life in the United States: A Population Health Perspective

Keywords: spinal stenosis, laminectomy, quality of life, review, outcome

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     Relative impact common disease states have on quality of life is poorly understood.
     In a systematic literature review, we determined mean quality-adjusted life year(QALY) of lumbar spondylosis versus other common chronic disease states and utilize U.S. prevalence rates to determine the relative impact these common diseases states have on U.S. population health.
     Systematic literature review was conducted for studies utilizing health state instrument(EQ-5D). Studies examining ten common disease states (both surgical and non-surgical) were included. Baseline health state for each disease state was recorded from the literature. Mean health state per disease state was multiplied by Center for Disease Control reported disease prevalence rates to determine overall annual QALY lost per disease state in U.S.
     137 studies(135,106 patients) met inclusion criteria. Lumbar spondylosis patients had cumulative mean EQ-5D of 0.39, the lowest QALY among all disease states examined. Lumbar spondylosis, knee osteoarthritis, COPD, and diabetes mellitus were the most prevalent disease states. Estimated total annual QALYs lost in the U.S. was greatest for lumbar spondylosis (18,391,456 QALYs); 1.34-fold greater than knee osteoarthritis, 2.6-fold greater than COPD and diabetes, 4.34-fold greater than degenerative hip disease.
     This is a retrospective literature review.
     Lumbar spondylosis was associated with lowest QALY health state compared to other common disease states. Impact on QALYs lost for U.S. population is significantly higher for lumbar spondylosis than disease states studied, suggesting degenerative lumbar spinal disorders have a large and detrimental impact on U.S. population’s health and quality of life.
     Healthcare reform initiatives should allocate appropriate resources and spending to address this high-impact disease process.


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