Original articleFactors associated with non-pharmacological, non-operative treatment utilization prior to thoracolumbar spine surgery in Manitoba: A Canadian Spine Outcomes Research Network (CSORN) study☆
Section snippets
Design
The authors performed a retrospective analysis of the CSORN data registry in XXXXXXXX, Canada to determine associated factors for chiropractic and/or physiotherapy engagement amongst CSORN patients eligible for ETSS.
Data collection
The primary objective of CSORN is to track patient socio-demographic data and outcomes across Canada. The CSORN registry captures data to answer questions relating to current practices in spine care. Patients are granted access to provide responses via initial paper-based patient
Results
Male patients represented approximately half (54.2%) of eligible CSORN patients in the XXXXXXXX database. While there was a wide range of patient ages (minimum age 22 years old, maximum 86 years old), the mean age was 52.5 years (SD = 17.7). Patients self-reported their height and weight, and BMI was subsequently calculated. The average BMI was 29.8 (SD = 6.3), based on 144 unique respondents, which is considered overweight (CDC., 2017; WHO). The average NRS reported was 6.7 (SD = 2.6)
Discussion
The present study revealed that 41.7% of CSORN patients in XXXXXXXX, Canada were progressing towards ETSS assessment despite displaying minimal-to-no engagement with non-pharmacological, non-operative treatment first. This is contrary to the generally accepted recommendation that a trial of non-pharmacological, non-operative treatment should precede elective spine surgery (Porchet et al., 1999; Airaksinen et al., 2006; Beyer et al., 2016). A similar pattern of disconnect with utilization of
Conclusion
The management of back pain continues to be problematic and challenging for clinicians. The creation of CPGs may have helped to steer clinicians toward evidence-based practice, but adoption of the guidelines remains challenging. The current study found 41.7% of CSORN patients had minimal engagement with non-pharmacological, non-operative treatment in the six-months prior to ETSS assessment in XXXXXXXX. Patients who had higher odds of minimal-to-no engagement in the six-months leading up to ETSS
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Declaration of competing interest
The authors report no conflict of interest. The authors alone are responsible for the content and composition of the manuscript.
Acknowledgements
The authors wish to thank the administration, board and patients of the XXXXXXXXX and the XXXXXXXXXX for their encouragement to pursue this project.
The proposed study was approved by the XXXXXXXXXXXX Health Research Ethics Board (HREB).
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