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[Variation in chemonucleolysis as treatment in herniated intervertebral disk]
1Academisch Medisch Centrum, afd. Neurologie, Amsterdam.
Nederlands Tijdschrift Voor Geneeskunde
|August 31, 1996
Summary
Chemonucleolysis use for lumbar disc herniation varied significantly in the Netherlands between 1987-1995. Specialist preferences likely drove these considerable variations in treatment.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Neurology
Background:
- Chemonucleolysis is a treatment for lumbosacral intervertebral disk herniation.
- Understanding treatment variation is crucial for healthcare management.
Purpose of the Study:
- To measure the variation in chemonucleolysis use for lumbosacral intervertebral disk herniation in the Netherlands.
- To analyze temporal, inter-specialist, and geographical variations in treatment.
Main Methods:
- A descriptive study was conducted in the Netherlands.
- Chymopapain sales data and specialist numbers were used to calculate per-specialist usage from 1987 to 1995.
- Variations in time, between specialists, and geographically were assessed.
Main Results:
- Chemonucleolysis treatments decreased from 2084 to 538 between 1987 and 1995.
- Most specialists did not use chemonucleolysis; a minority performed the majority of treatments.
- Treatments were concentrated in non-academic hospitals outside urban western Holland.
Conclusions:
- Considerable variation exists in the management of lumbosacral intervertebral disk herniation using chemonucleolysis in the Netherlands.
- Specialist preferences are the probable cause of this observed variation.