Prevalence and Risk of Urinary Dysfunction in Cervical and Lumbar Degenerative Spinal Disease: A Large-Scale Population-Based Study
Soo-Bin Lee, Ji-Won Kwon, Seong-Hwan Moon, Kyung-Soo Suk, Hak-Sun Kim, Si-Young Park, Byung Ho LeeStudy Design
Retrospective observational study.
Objectives
Degenerative spinal disease, most commonly affecting the cervical and lumbar regions, is a leading cause of disability among the elderly, with its prevalence rising globally. Although urinary dysfunction is a recognized complication, its prevalence and associated risk have not been systematically evaluated in a large-scale population-based setting.
Methods
Data from the Korean Health Insurance Review and Assessment Service were analyzed using eight annual datasets from 2009 to 2016, each representing a 3% random sample of the national population. Patients were categorized into cervical, lumbar, combined, and control groups. Meta-analysis was conducted to calculate pooled prevalence of urinary dysfunction. Multivariable logistic regression incorporating age, sex, and Charlson Comorbidity Index score was performed to estimate adjusted odds ratios, which were subsequently meta-analyzed to derive pooled effect sizes.
Results
The mean number of patients across datasets was 455,461. The pooled prevalence of urinary dysfunction was 8.7% (95% CI, 8.1–9.3%) in the cervical group, 9.1% (95% CI, 8.3–9.9%) in the lumbar group, 13.7% (95% CI, 12.8–14.7%) in the combined group, and 5.2% (95% CI, 4.8–5.5%) in controls. The pooled adjusted odds ratios were 1.58 (95% CI, 1.52–1.65) for cervical disease, 1.49 (95% CI, 1.47–1.51) for lumbar disease, and 2.24 (95% CI, 2.16–2.33) for combined disease.
Conclusions
Cervical and lumbar degenerative spinal disease are independently associated with increased urinary dysfunction risk, with the highest risk in patients with combined involvement. Clinicians should be attentive to urinary symptoms in this population, particularly when both regions are affected.