Back and Neck Impairment
                            Statistics References

AAOS, Musculoskeletal Conditions in the U.S., Feb 1992:

   * 1988 National Health Interview Survey found:
   * 29.9 million people reported musculoskeletal impairments.
   * Back/spine was most frequent, representing 51.7%
   * Impairment is most prevalent in 45-64 year old group
   * Rate 124/1000 persons

1988 National Hospital Discharge Survey:

   * 3,513,000 total musculoskeletal conditions (4th behind obstetrical,
     gastrointestinal and cardiovascular)
   * 3,009,000 Total musculoskeletal surgical procedures
   * 46.9% (1,647,000 ) Due to musculoskeletal disease and connective tissue
     disorder
   * 417,000 Intervertebral disc disorders
   * 178,000 Other back disorders
   * 250,000 Disc excision/destruction
   * 90,000 Spinal fusion
   * 14.3 million office visits for conditions associated with back pain
   * 4.1 million report disc disorders
   * Dvorak, et al, Spine 13(12): 1418-22, December 1988
        o Determined 17% reoperation rate of back surgery
   * Heithoff, et al, Orthopaedic Clinics of North America, 16(3): 417-44,
     July 1983
        o 25,000-50,000 failed back surgery syndrome cases occur each year
   * Deyo, et al, Spine, 18(11): 1463-70, September 1993
        o Re-operation rate 6.9% overall at 2 year follow up
        o 11.9% (fusion vs. 10.2% (non-fusion) at 4 year follow up
        o Re-hospitalization 22.4% (fusion) vs. 18.3% (non-fusion)
   * Bruske-Hohlfield, et al, Spine 15(1): 31-5, January 1990
        o Age & sex adjusted incidence rate for surgery on prolapsed lumbar
          discs:
        o 52.3/100,000 overall, 46.3/100,000 for initial operations
   * Frymoyer, et al, Spine 3(1), 7-11, March 1978
        o Overall failure rate
        o 30% (fusion), 37.7% (non-fusion)
        o 80% of Americans will suffer some type of back pain in their
          lives.
        o (American Academy of Orthopaedic Surgeons.)
   * Back pain is the second leading cause of absenteeism from work, after
     the common cold. (AAOS) Back pain is the second most common medical
     complaint. (The New England Medical Journal.)
   * Back injuries cause 100 million lost days of work annually. (Safety &
     Health publication, 1992.)
   * Work-related back injuries are the country's number one occupational
     hazard. 2% of the nation's workforce, (450,000 people), sustain back
     injuries each year. (Business & Health, 1992.)
   * Back injuries are the most costly for employers. The cost for back pain
     injury claim far surpasses others. The average total cost per claim in
     1989, was $18,365. (Business & Health.)
   * The total cost of back injury disabilities is between $30 billion and
     $60 billion annually. (National Safety Council.)
   * After 52 weeks of back injury disabilities, only 25% of injured workers
     return to work. After two years of disability, the return rate is zero.
     (Business Insurance Publication, 1992.)
   * For 85% of back pain sufferers, the primary site of back pain is the
     lower back. (AAORS)
   * An estimated 4.1 million persons each year report disk disorders which
     are a major contributor to back pain. (AAORS)
   * More than $126 billion a year is spent in medical care and lost
     productivity due to musculoskeletal conditions-disorders and injuries
     of the bones, joints, ligaments, tendons, muscles and nerves...and are
     among the most frequently occurring medical conditions. (AAORS)
   * There are 46,000 disabling back injuries each year. (Safety & Health
     publication, 1988.)