STUDY DESIGN: Retrospective medical record review. OBJECTIVE: To (1) determine if outpatient referrals for low back pain (LBP) and leg pain triaged through a multidisciplinary spine care pathway (group A) were more likely to be candidates for surgery than conventional physician referrals (group B); (2) compare relevant clinical differences in the 2 groups (e.g., diagnosis, pain scores, level of disability); and (3) compare wait times for magnetic resonance imaging and surgical assessment. SUMMARY OF BACKGROUND DATA: The Saskatchewan Spine Pathway was introduced on the basis of evidence that a co-ordinated, multidisciplinary, and stratified approach to the assessment and management of LBP may improve quality. During early implementation, some physicians began to refer patients to Saskatchewan Spine Pathway clinics, whereas others continued to refer patients directly to the surgeon through the conventional process. METHODS: We retrospectively analyzed consecutive new outpatient referrals for LBP and leg pain, June 1, 2011 through May 30, 2012 for 2 surgeons. RESULTS: We identified 215 referrals, including 66 (30.7%) in group A and 149 (69.3%) in group B. There was no difference in overall health (mean EuroQol Group 5-Dimension Self-Report Questionnaire visual analogue scale) or lower back-related disability score (Oswestry Disability Index). Group A patients were significantly more likely to be candidates for surgery (59.1% vs. 37.6% for group B; P = 0.0034, χ test), had significantly poorer scores for EuroQol Group 5-Dimension Self-Report Questionnaire mobility, a higher proportion of leg dominant pain, and a lower proportion of back dominant pain. Group A patients also had significantly shorter wait times for magnetic resonance imaging and surgical assessment. CONCLUSION: A co-ordinated multidisciplinary pathway with a stratified approach to LBP assessment and care provided a greater proportion of surgery candidates than the conventional referral process. The implementation of such processes may allow surgeons to restrict their practices to patients who are more likely to benefit from their services, thereby reducing wait times and potentially reducing costs. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Retrospective medical record review. OBJECTIVE: To (1) determine if outpatient referrals for low back pain (LBP) and leg pain triaged through a multidisciplinary spine care pathway (group A) were more likely to be candidates for surgery than conventional physician referrals (group B); (2) compare relevant clinical differences in the 2 groups (e.g., diagnosis, pain scores, level of disability); and (3) compare wait times for magnetic resonance imaging and surgical assessment. SUMMARY OF BACKGROUND DATA: The Saskatchewan Spine Pathway was introduced on the basis of evidence that a co-ordinated, multidisciplinary, and stratified approach to the assessment and management of LBP may improve quality. During early implementation, some physicians began to refer patients to Saskatchewan Spine Pathway clinics, whereas others continued to refer patients directly to the surgeon through the conventional process. METHODS: We retrospectively analyzed consecutive new outpatient referrals for LBP and leg pain, June 1, 2011 through May 30, 2012 for 2 surgeons. RESULTS: We identified 215 referrals, including 66 (30.7%) in group A and 149 (69.3%) in group B. There was no difference in overall health (mean EuroQol Group 5-Dimension Self-Report Questionnaire visual analogue scale) or lower back-related disability score (Oswestry Disability Index). Group A patients were significantly more likely to be candidates for surgery (59.1% vs. 37.6% for group B; P = 0.0034, χ test), had significantly poorer scores for EuroQol Group 5-Dimension Self-Report Questionnaire mobility, a higher proportion of leg dominant pain, and a lower proportion of back dominant pain. Group A patients also had significantly shorter wait times for magnetic resonance imaging and surgical assessment. CONCLUSION: A co-ordinated multidisciplinary pathway with a stratified approach to LBP assessment and care provided a greater proportion of surgery candidates than the conventional referral process. The implementation of such processes may allow surgeons to restrict their practices to patients who are more likely to benefit from their services, thereby reducing wait times and potentially reducing costs. LEVEL OF EVIDENCE: 3.
Authors: Mohammad Zarrabian; Andrew Bidos; Caroline Fanti; Barry Young; Brian Drew; David Puskas; Raja Rampersaud Journal: Can J Surg Date: 2017-10 Impact factor: 2.089
Authors: Johanna M van Dongen; Miranda L van Hooff; Maarten Spruit; Marinus de Kleuver; Raymond W J G Ostelo Journal: Eur Spine J Date: 2017-06-30 Impact factor: 3.134
Authors: Ishan Naidu; Jessica Ryvlin; Devin Videlefsky; Jiyue Qin; Wenzhu B Mowrey; Jong H Choi; Chloe Citron; James Gary; Joshua A Benton; Brandon T Weiss; Michael Longo; Nabil N Matmati; Rafael De la Garza Ramos; Jonathan Krystal; Murray Echt; Yaroslav Gelfand; Phillip Cezayirli; Neeky Yassari; Benjamin Wang; Erida Castro-Rivas; Mark Headlam; Adaobi Udemba; Lavinia Williams; Andrew I Gitkind; Reza Yassari; Vijay Yanamadala Journal: J Clin Med Date: 2022-05-05 Impact factor: 4.964