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THE REALITY OF AUDIT OF SPINAL SURGERY



Abstract

Clinical governance encompasses audit. Audit is a requirement of our professional bodies and our hospital trusts. It is not usually resourced adequately and the ability to audit spinal surgical outcomes is haphazard nationally. This presentation describes the results that can be achieved in the absence of formal audit support.

A surgical database was started in 1993; its evolution involved the use of standard outcome measures in 1995. Between 1995 and 1999, four hundred and one major spine procedures were undertaken by a single surgeon. The outcome measures were the Oswestry disability index, the low back outcome, MSP MZD and a visual analogue pain scale.

Pre-operative data was collected on all 233 elective cases. Follow up was 59% at 6 months, 51% at one year and 57% at 2 years. At two years a Macnab score was available in 106 cases and the results were excellent/ good 81%, fair/poor 19%.

There were 56 recorded perioperative complications. 21 occurred in the 77 instrumented procedures and 35 in the 156 non instrumented procedures.

The results of this type of audit can only be cautiously compared to published data because of poor follow up. Quality outcome measures and audit probably require a funded resource to be of value.

Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK

BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.