South African spine surgeons show high treatment variation

A survey of 79 spine surgeons in South Africa has revealed significant variability in how spinal pathologies are treated. The study investigated decision-making processes for various conditions, including cervical spine distractive flexion injury, lumbar disc herniation, degenerative spondylolisthesis with stenosis, and insufficiency fractures.

Researchers found moderate to high levels of variation in treatment for cervical spine injuries and insufficiency fractures. The study noted that surgeon characteristics, such as caseload, experience, training, and external funding, were key factors influencing treatment selection. Notably, 19% of the surveyed surgeons chose treatment options that were not supported by a panel of spine specialists.

The findings suggest a need for greater uniformity in treatment and more accessible reporting of patient outcomes to support value-based care. The study concludes that increased investment in training, fellowship programs, and the dissemination of medical literature may be necessary to standardize management.