Burden of Sciatica on US Medicare Recipients

Joseph P. Maslak, Tyler J. Jenkins, Joseph A. Weiner, Abhishek S. Kannan, Daneel M. Patoli, Michael H. McCarthy, Wellington K Hsu, Alpesh A. Patel

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: This study evaluates the disease burden of sciatica on the US Medicare cohort. BACKGROUND DATA: Sciatica is a common disability that has important physical, mental, and economic effects. The Medicare Health Outcomes Survey (HOS) is a demographic and outcomes survey used to monitor the performance of Medicare Advantage health plans in the United States. The HOS includes data on demographics, chronic medical conditions, and patient-reported outcomes. METHODS: Medicare HOS data for cohorts from 2007 to 2013 were obtained. Patients were placed into two categories based on the survey results: with or without a history of sciatica. Baseline demographics, chronic medical conditions, and physical health symptoms were aggregated. In addition, average VR-12 physical component summary and mental component summary scores were calculated for each group at baseline and at 2-year follow-up. A Fisher exact test was used to assess significance for categorical variables, and a t-test was used for continuous variables. VR-12 changes as small as 1 to 2 units have been found to be clinically and socially relevant. RESULTS: The baseline cohort data of 1,000,952 patients yielded 250,869 patients (25%) who reported the diagnosis of sciatica, compared with 750,083 patients (75%) without sciatica. Patients with a history of sciatica tended to be younger, less educated, and notably with more medical comorbidities. Physical component summary outcomes were approximately 8 units lower in the sciatica group at baseline and 7 units lower at 2-year follow-up. Mental component summary outcomes were 6 units lower in the sciatica group at baseline and 5 units lower at 2-year follow-up. CONCLUSION: A large percentage of the US Medicare cohort suffers from symptomatic sciatica. Our study identified a 25% prevalence in the Medicare cohort. In addition, sciatica is associated with an increased incidence of comorbid medical conditions and poor health-related quality of life. LEVEL OF EVIDENCE: Level III STUDY DESIGN:: Observational-Cohort Study.

Original languageEnglish (US)
Pages (from-to)e433-e439
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume28
Issue number10
DOIs
StatePublished - May 15 2020

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    Maslak, J. P., Jenkins, T. J., Weiner, J. A., Kannan, A. S., Patoli, D. M., McCarthy, M. H., Hsu, W. K., & Patel, A. A. (2020). Burden of Sciatica on US Medicare Recipients. The Journal of the American Academy of Orthopaedic Surgeons, 28(10), e433-e439. https://doi.org/10.5435/JAAOS-D-19-00174