{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T05:16:09Z","timestamp":1776575769155,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,8,16]],"date-time":"2018-08-16T00:00:00Z","timestamp":1534377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005925","name":"Buddhist Tzu Chi Medical Foundation","doi-asserted-by":"publisher","award":["105\u201001\u201001"],"award-info":[{"award-number":["105\u201001\u201001"]}],"id":[{"id":"10.13039\/501100005925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005925","name":"Buddhist Tzu Chi Medical Foundation","doi-asserted-by":"publisher","award":["105\u201001\u201002"],"award-info":[{"award-number":["105\u201001\u201002"]}],"id":[{"id":"10.13039\/501100005925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the risk of the need for spine surgery, including cervical and lumbar spine surgeries in patients with ankylosing spondylitis (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>), compared with those without the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A secondary data analysis was conducted using population\u2010based claims data from the Taiwan National Health Insurance Research Database. Adult patients with newly diagnosed <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> between January 2000 and December 2012 were identified based on the International Classification of Diseases, Ninth Revision, Clinical Modification code 720.0. A comparison cohort was assembled using frequency\u2010matched sex, 10\u2010year age intervals, and index year with the <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> cohort at a ratio of 5:1. All patients were followed until our study outcomes (any spine surgery, cervical spine surgery, and lumbar spine surgery), based on surgical codes, had occurred, or until the end of the followup period. Incidence rate ratios (<jats:styled-content style=\"fixed-case\">IRR<\/jats:styled-content>s) were calculated using Poisson regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 3,462 patients with <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> and 17,310 patients without <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>. All 3 outcome variables were seen at a significantly higher incidence in the <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> cohort than in the comparison cohort (<jats:styled-content style=\"fixed-case\">IRR<\/jats:styled-content> 2.34 [95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.92\u20132.87] for any spine surgery, <jats:styled-content style=\"fixed-case\">IRR<\/jats:styled-content> 2.36 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.55\u20133.59] for cervical spine surgery, and <jats:styled-content style=\"fixed-case\">IRR<\/jats:styled-content> 2.33 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.85\u20132.93] for lumbar spine surgery). Moreover, the magnitudes of the <jats:styled-content style=\"fixed-case\">IRR<\/jats:styled-content>s were the largest in the youngest age group (individuals in their 20s and 30s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, particularly those in their 20s and 30s, had a significantly higher risk of needing any spine surgery, cervical spine surgery, and lumbar spine surgery, compared with patients without <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23478","type":"journal-article","created":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T12:14:02Z","timestamp":1511957642000},"page":"1416-1420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incident Spine Surgery in Patients With Ankylosing Spondylitis: A Secondary Cohort Analysis of a Nationwide, Population\u2010Based Health Claims Database"],"prefix":"10.1002","volume":"70","author":[{"given":"Ming\u2010Chi","family":"Lu","sequence":"first","affiliation":[{"name":"Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan School of Medicine Tzu Chi University Hualien City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm","family":"Koo","sequence":"additional","affiliation":[{"name":"Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning\u2010Sheng","family":"Lai","sequence":"additional","affiliation":[{"name":"Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan School of Medicine Tzu Chi University Hualien City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22831"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817c6c64"},{"issue":"2","key":"e_1_2_6_4_1","first-page":"218","article-title":"Fractures of the thoracolumbar spine complicating ankylosing spondylitis","volume":"97","author":"Hitchon PW","year":"2002","journal-title":"J Neurosurg"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-016-3524-1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108217"},{"key":"e_1_2_6_8_1","first-page":"1","article-title":"Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey","volume":"4","author":"Liu CY","year":"2006","journal-title":"J Health Manag"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.060293"},{"key":"e_1_2_6_10_1","first-page":"419","article-title":"Gender\u2010attributable differences in outcome of ankylosing spondylitis: long\u2010term results from the Outcome in Ankylosing Spondylitis International Study","volume":"55","author":"Webers C","year":"2016","journal-title":"Rheumatology (Oxford)"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39464"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31818edcfd"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2011.3.1.34"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012664"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38070"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177231"}],"container-title":["Arthritis Care &amp; 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