ArticleSpine2019
Utilization and Outcomes for Spine Surgery in the United States and Canada.
Article in Spine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of exercise-based prehabilitation for patients undergoing elective spinal surgery: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Late-onset Spinal Infection Caused byPlastic and reconstructive surgery. Global open · 2026Article
- Understanding the complexity of surgical decision-making for individuals with symptomatic lumbar spinal stenosis: A qualitative study.Chiropractic & manual therapies · 2025Article
- Association between preoperative activity levels and postoperative complications in adult spinal deformity surgery.Spine deformity · 2025Article
- Opioid-Induced Hyperalgesia and Inflammaging in the Management of Spine Pain: The Case for Genetically Directed Dopamine Homeostasis.International journal of spine surgery · 2025Article
- A systematic review of evidence comparing spinal cord stimulation to sham or conservative medical management in the treatment of persistent spinal pain syndrome - Type 2.Interventional pain medicine · 2025Review
- Prior year hospital admission predicts 30-day hospital readmission after spine surgery.North American Spine Society journal · 2025Article
- The impact of elective spine surgery in Canada for degenerative conditions on patient reported health-related quality of life outcomes.Scientific reports · 2025Observational
- Human-centered design of a health recommender system for orthopaedic shoulder treatment.BMC medical informatics and decision making · 2025Article
- An evaluation of fusion status following lumbar fusion surgery utilizing multi-planar computed tomography.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- The FDA Reclassification of Cervical Pedicle and Lateral Mass Screws: A Case Study in Regulatory History.Therapeutic innovation & regulatory science · 2024Review
- A Pharmacogenomics-Based In Silico Investigation of Opioid Prescribing in Post-operative Spine Pain Management and Personalized Therapy.Cellular and molecular neurobiology · 2024Article
- Human-centered Design of a Health Recommender System for Orthopaedic Shoulder Treatment.Research square · 2024Article
- Intensive Care Unit Admission After Spine Surgery: A Narrative Review.International journal of spine surgery · 2024Article
- Article
- Rates and Characteristics of Patients Leaving against Medical Advice after Spine Surgery.Spine surgery and related research · 2024Article
- Variation in care for patients presenting with hip fracture in six high-income countries: A cross-sectional cohort study.Journal of the American Geriatrics Society · 2023Article
- Optimizing Patient Outcomes in Spinal Surgery: An Investigation Into Anesthesiologists' Case Volume.Cureus · 2023Article
- Emergency department utilization, admissions, and revisits in the United States (New York), Canada (Ontario), and New Zealand: A retrospective cross-sectional analysis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Incidence of spine surgery in the South African private healthcare sector: ten-year trends within a large open medical scheme.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
Corrections and comments
- Commented on by
Authors and funding
7 authors.
Funding
Abstract
STUDY
designA retrospective cohort study.
objectiveThe aim of this study was to examine variation in spine surgery utilization between the province of Ontario and state of New York among all patients and pre-specified patient subgroups. SUMMARY OF BACKGROUND DATA: Spine surgery is common and costly. Within-country variation in utilization is well studied, but there has been little exploration of variation in spine surgery utilization between countries.
methodsWe used population-level administrative data from Ontario (years 2011-2015) and New York (2011-2014) to identify all adults who underwent inpatient spinal decompression or fusion surgery using relevant procedure codes. Patients were stratified according to age and surgical urgency (elective vs. emergent). We calculated standardized utilization rates (procedures per-10,000 population per year) for each jurisdiction. We compared Ontario and New York with respect to patient demographics and the percentage of hospitals performing spine surgery. We compared utilization rates of spinal decompression and fusion surgery in Ontario and New York among all patients and after stratifying by surgical urgency and patient age.
resultsPatients in Ontario were older than patients in New York for both decompression (mean age 58.8 vs. 51.3 years; P < 0.001) and fusion (58.1 vs. 54.9; P < 0.001). A smaller percentage of hospitals in Ontario than New York performed decompression (26.1% vs. 54.9%; P < 0.001) or fusion (15.2% vs. 56.7%; P < 0.001). Overall, utilization of spine surgery (decompression plus fusion) in Ontario was 6.6 procedures per-10,000 population per-year and in New York was 16.5 per-10,000 per-year (P < 0.001). Ontario-New York differences in utilization were smaller for emergent cases (2.0 per 10,000 in Ontario vs. 2.5 in New York; P < 0.001), but larger for elective cases (4.6 vs. 13.9; P < 0.001). The lower utilization in Ontario was particularly large among younger patients (age <60 years).
conclusionWe found significantly lower utilization of spine surgery in Ontario than in New York. These differences should inform policy reforms in both jurisdictions. LEVEL OF EVIDENCE: 3.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.