• Tom Asklöf, Hannu Kautiainen, Salme Järvenpää, Maija Haanpää, Ilkka Kiviranta, and Timo Pohjolainen.
• *Department of Orthopedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland †Unit of Family Practice, Central Finland Central Hospital, Jyvaskyla, Finland ‡Medcare Foundation, Aanekoski, Finland §Department of Neurosurgery, Helsinki University Central Hospital, Finland ¶Department of Orthopedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland; and ‖ORTON Rehabilitation Centre, Helsinki, Finland.
• Spine. 2014 Mar 15;39(6):503-8.

Study DesignA register-based national study.ObjectiveTo describe the occurrence of spinal disorders (SDs) resulting in disability pension (DP) in Finland during 1990-2010.Summary Of Background DataThe indirect cost of SD is excessive. The most significant indirect cost is due to DP. There are no nationwide long-term studies of DP trends caused by SDs.MethodsThe study setting consisted of Finnish working population (20-64 yr). All new cases were identified from the nationwide register maintained by the Finnish Centre of Pensions from the beginning of 1990 to the end of 2010. The data included sex, age group, year of the DP decision, and the main cause of incapacity (diagnosis) leading to DP. Main outcome measure was DPs due to SDs.ResultsA total of 84,375 individuals (40,415 females; 43,960 males) received DP during the study period. Age- and sex-adjusted incidence rate ratio was 0.45 (95% CI: 0.44-0.46) between time periods of 1990-1994 and 2005-2010. In males, crude incidence in 1990-1994 was 21.0 (95% CI: 20.6-21.3) per 10,000 person-years and in 2005-2010, it was 11.1 (10.9 to 11.3). In females, it was 18.8 (95% CI: 18.5-19.1) and 11.4 (95% CI: 11.1-11.6). During the study period, the overall DP rate also decreased. Age- and sex-adjusted incidence rate ratio was 0.66 (95% CI: 0.65-0.67) between the time periods 1990-1994 and 2005-2010. However, the proportion of DPs due to the SDs of all new DPs was higher in the first half of 1990s than in 2005-2010 (adjusted proportion 19.6% [95% CI: 19.4-19.8] vs. 14.4% [95% CI: 14.2-14.6]).ConclusionThe occurrence of DPs due to SDs has decreased significantly during the period of 1990-2010 in Finland. On the basis of the register data, nonmedical factors and legislative reforms may explain the decrease of DPs more than treatments provided by health care.Level Of Evidence3.

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