Cervical disc herniation epidemiology

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In a Hispanic Puerto Rico population, the most prevalent operated degenerative cervical disc levels were C5-C6 and C4-C5 ¹⁾

Descriptions of the epidemiology of cervical disc herniation (CDH) can be gathered from a few large series, such as the highly cited study from the group in Rochester which included 561 patients with cervical radiculopathy and did not attempt to distinguish those with CDH ²⁾.

With regard to age, the Rochester study reported that the mean age of men with cervical radiculopathy was 47.6 and for women was 48.2 ³⁾.

Of the 332 males and 229 females, ages 13-91, studied in that report, 21.9% had a confirmed disc protrusion. Other studies suggest that the types of cervical disc herniation presentations tend to be age specific and related to various habits or occupations such as those requiring heavy lifting or activities involving repeated axial loading ⁴⁾.

A significant number of asymptomatic disc herniation (DH) cases may be present as well ^{5) 6)}

However, these results have been limited to a certain age group, region, occupation, or group and cannot be referred to when evaluating the occurrence distribution in all age groups or the differences in DH incidence between men and women according to age ^{7) 8) 9) 10) 11) 12) 13) 14)} thereby limiting their generalizability. The limitations of these epidemiological studies are attributed to the lack of analysis of nationwide diagnosis documents which until now had been impossible. However, since big data analysis has become a major aspect of medical studies, several attempts have been made to analyze all health insurance data and identify the distribution of disease occurrence ¹⁵⁾.

In South Korea, health insurance data have become public, enabling the study of the distribution of disease occurrence through analysis of the data from the whole country.

Generally, identifying the distribution of disease occurrence is crucial for preventing a disease and determining the association between occupational factors and disease occurrence in order to determine worker’s compensation. Therefore, in this study, we analyzed health insurance data to identify the distribution of symptomatic CDH and LDH occurrence according to age, sex, and workforce eligibility for national health insurance. Asymptomatic DH was excluded from the analysis as its presence could not be determined from health insurance data. The qualification for health insurance varies with the characteristics of the tasks performed in the workplace. The reason for investigating the distribution of incidence by eligibility was to determine whether there were differences in the incidence of DH according to type of labor, as the nature and type of labor performed by the subscribers may vary according to their eligibility ¹⁶⁾.

Cervical disc herniation (CDH) is the most common cause of cervical radiculopathy and could overlap with fibromyalgia (FM).The prevalences of FM and widespread pain in patients with CDH were found as 11.5% and 78.8% respectively ¹⁷⁾.