• Sung Hoon Choi, Ja Wook Koo, DaeHyun Choe, and Chang-Nam Kang.
• Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea.
• Spine. 2020 Jul 15; 45 (14): E856-E863.

Study DesignPopulation-based study. From 2008 to 2017, data from the national database of the Korean Health Insurance Review & Assessment Service were analyzed. The national insurance system and all medical expense bill data of the entire population are included in the database.ObjectiveThe aim of this study was to elucidate the incidence and management trends of metastatic spinal tumors in South Korea.Summary Of Background DataThe spine is the most common location of bone metastases. However, population-based studies in this topic are limited.MethodsThe International Classification of Disease, 10th revision, medical behavior, and examination codes were used to identify the incidence and management trends of metastatic spinal tumors. The Cochran-Armitage trend test was used in statistical analysis.ResultsOverall, 38,007 patients (average age, 61 years) diagnosed with metastatic spinal tumors were analyzed. Metastatic tumors were most common in patients in their 60s (25.7%). The 10-year incidence of spinal metastases in South Korea was 6.68 cases per 100,000 population. The age-adjusted incidence per 100,000 population decreased from 8.16 cases in 2008 to 6.18 in 2017 (P = 0.03). Sex-adjusted incidence rates in men increased from 8.60 per 100,000 persons in 2008 to 8.70 in 2017 (P < 0.001); those of women decreased from 8.20 per 100,000 persons in 2008 to 4.15 in 2017 (P < 0.05). The most common primary tumor site was the lung (26.9%), followed by the breast (16.9%), prostate (10.8%), and liver (8.1%). Radiation therapy was constant at about 3500 cases per annum (P = 0.62); surgical treatment increased from 1158 to 1382 cases (P < 0.001). Resection and instrumentation surgeries increased significantly (P < 0.001), whereas cementation decreased continuously. Total healthcare costs increased significantly from $19,925,296 in 2008 to $30,268,217 in 2017 (P < 0.001).ConclusionThe incidence of metastatic spinal tumors decreased in South Korea. Resection and instrumentation procedures increased, and total healthcare costs increased rapidly.Level Of Evidence3.

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