Traditional Korean Rehabilitation Medicine and Long-Term Health Outcomes after Lumbar Spine Surgery: A Nationwide Propensity-Matched Cohort Study.

INTRODUCTION

Unplanned readmission, institutionalization, and early mortality remain common after lumbar spine surgery, especially in older adults. Traditional Korean rehabilitation medicine (TKRM) is widely used in Korea, yet its long-term impact on postoperative outcomes has not been clarified.

METHODS

In this nationwide, retrospective cohort study, National Health Insurance Service claims data from 2019 to 2021 were used to identify 30,022 adults discharged after lumbar surgery. Propensity-score matching (1:1) produced 11,938 comparable patients who either received TKRM within 6 months of discharge or usual care alone. Cox proportional-hazards models estimated adjusted hazard ratio (aHRs) for readmission, entry into long-term care, and all-cause mortality over 6-24 months; dose-response effects were examined across quartiles of cumulative TKRM visits, and diagnosis-specific subgroup analyses contrasted intervertebral disc disorders with spinal stenosis.

RESULTS

Early TKRM use was associated with significantly lower risks of readmission (aHR 0.49; 95% confidence interval 0.32-0.75), entry into long-term care (0.36; 0.21-0.62), and mortality (0.49; 0.32-0.75). A graded inverse relationship was observed: patients in the highest exposure quartile showed the greatest benefit (aHR for readmission: 0.24; long-term care facility: 0.12; mortality: 0.16). Protective effects were most pronounced in intervertebral disc disorders, whereas reductions in readmission did not reach significance for spinal stenosis.

CONCLUSIONS

Utilization of TKRM within the first six postoperative months is associated with sustained reductions in unplanned readmission, entry into long-term care, and all-cause mortality after lumbar surgery, with a clear dose-response relationship. These findings suggest that early TKRM use may be associated with improved postoperative outcomes following lumbar surgery, although further research is needed to confirm these associations.