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Development and Implementation of a National Canadian Spine Surgery Registry

Teaser: 

1Greg McIntosh,2Dr. Michael Craig, 3Dr. Charles Fisher,

1Director of Research Operations, Canadian Spine Outcomes and Research Network.
2Neurosurgery Resident at Vancouver General Hospital, University of British Columbia. 3Professor and Head of the Division of Spine Surgery, Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia.

CLINICAL TOOLS

Abstract:The goal of the Canadian Spine Outcomes and Research Network (CSORN) is to develop a registry for Canadian orthopaedic and neurosurgical spine surgeons to participate in prospective multi-centre trials and retrospective reviews utilizing multivariable analyses. The design allows ongoing research and contains clinical details necessary for epidemiological assessment. Currently, 21 hospital sites, representing 9 provinces, participate CSORN. A total of 81 investigators have enrolled over 11,000 spine patients; 78% thoracolumbar and 22% cervical. Predictive models, effectiveness of surgical procedures, wait time issues and patient-surgeon expectations are some of the specific topics already published with CSORN data.
Key Words: registry, spine surgery, data quality, outcomes.

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Collection, feedback and publication of registry data is now a recognized way of informing clinical practice, driving quality improvement and improving patient outcomes.
The Canadian Spine Outcomes and Research Network (CSORN) is a multicentre national initiative that prospectively enrols consecutive patients with spinal pathology requiring surgical treatment.
The CSORN registry is designed to assess the value of operative techniques on patient outcomes.
Both patients and providers can feel powerless to enact any real change over the healthcare system. Patient participation in a properly designed registry gives them the opportunity to contribute to improving healthcare delivery.
The need for documentation of clinical outcomes is as important in spinal surgery as it is in other medical specialties.
If the value of spine surgery is not well established, then the cheapest options, rather than potentially better ones, are more likely to be endorsed.
Registries require fewer resources and often avoid the constraints of randomized clinical trials; as a result, registry findings usually have strong external validity and generalizability.
Collecting quality of life and patient-reported outcome measures data are essential for treatment evaluation.
Patients (and their physicians) should not fear participation in well-designed registries.
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