The need for quality registries has become central to emerging evidence-driven reforms, with Americans spending an estimated $850 billion annually on ineffective medical treatment.
And while many studies have demonstrated the efficacy of various surgical procedures for spinal disorders, few have examined their effectiveness in real-world settings or at the individual level.
A team of researchers led by Anthony L. Asher, MD, FAANS, has reviewed a nationwide, prospective, longitudinal outcomes database that measures the safety and effectiveness of everyday neurosurgical spine care. Using standardized sampling and linear regression, the team sought to identify predictors of 12-month surgical outcomes for lumbar disc herniation and spondylolisthesis.
The study, known as The National Neurosurgery Quality and Outcomes Database(N2QOD): Predictors of Persistent 12 month Disability Following Lumbar Surgery, revealed that while lumbar surgery for disc herniation and spondylolisthesis is highly effective in the real-world setting, a significant subset of patients does not report improved disability scores at 12 months.
Great variability in outcomes exists at the individual patient level, said Dr. Asher: "This variability has been observed at all participating centers, in all diagnoses, and in all procedures included in the registry. Making sense of this variability - specifically, determining the combined contribution of patient characteristics and other variables to specific clinical outcomes - will produce tremendous benefit for surgeons, their patients and other health-care stakeholders."