Surgeons at Washington State created the Spine Surgical Care and Outcomes Assessment Program to examine variability in use, process and outcomes of spine surgery, and published their findings in Spine.
The surgeons collected data from spinal fusion cases at the hospital and 30 percent sampling from other spine procedures from up to 20 hospitals for procedures performed between 2011 and 2013. There were 10,166 patients included in the study, with 3,767 undergoing lumbar surgery and 6,399 undergoing cervical procedures.
The researchers found:
1. Spinal fusion patients were 75.3 percent of the cohort and of those patients, 92.5 percent reported neurological symptoms.
2. The spinal fusion patients also reported baseline limb pain numeric rating scale scores of 5.9 on average, among those who had neurological symptom. The NRS score for back pain was 5.9.
3. The average Oswestry Disability Index/Neck Disability Index score was 44 for spinal fusion patients.
4. Researchers found significant inter-site variation among these factors:
• Smoking — range of 0 percent to 40 percent
• Combined adverse event rates — 10 hospitals had significantly lower observed/expected ratio and three had significantly greater observed to expected ratio
5. The researchers concluded, "This variability indicates the need for continued surveillance initiatives and point to opportunities for quality improvement and research."