Low back pain is a very common condition. Through the Saskatchewan Spine Pathway (SSP), primary care providers are educated about conservative management of low back pain, while specialized physiotherapists in Spine Pathway Clinics provide advanced assessment and expedited surgical referral for people who may benefit from spine surgery.
Saskatoon surgeons Dr. Daryl Fourney and Dr. Adam Wu recently attended the Canadian Spine Society Annual Scientific Conference in Toronto to present their research comparing outcomes for spine pathway patients to those who received conventional care.
Retrospective studies have shown the SSP facilitates quicker access to MRI and more appropriate surgical referrals. The objective of this study by Dr. Fourney was to compare surgical outcomes after triage through conventional processes or the Spine Pathway, with respect to baseline clinical features, indication for surgery, therapies received prior to surgery, type of surgery, wait times, overall patient satisfaction and outcome.
The research followed 150 patients who received spine surgery between 2011 and 2016. Seventy-five patients were assessed in a Spine Pathway Clinic before being referred to a spine surgeon. The other 75 patients were referred directly to a spine surgeon. Researchers concluded that there are minimal differences in post-surgical outcomes for SSP patients versus conventionally referred patients; however, wait times for MRI and non-operative treatment strategies were 47 days shorter for those in the Spine Pathway group. There was also a significant difference in pre-surgical patient satisfaction, with 46 per cent of patients in the SSP group reporting being "very satisfied" compared to only 14 per cent in the conventional treatment group.
"Saskatchewan has led the way by implementing the first provincial spine pathway in Canada,” says Dr. Fourney. “The pathway has been very useful in my practice because patient referrals are coordinated and there is a central focus on the patient experience through multidisciplinary care."
The Canadian Spine Society is a collaborative of spine surgeons and health care professionals with a primary interest in advancing excellence in spine patient care, research and education.
The Spine Pathway is a Saskatchewan initiative launched in 2010 to improve physician education and conservative management of lower back pain and facilitate access to specialty care for people with acute surgical conditions.
Dr. Daryl Fourney at Royal University Hospital