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Degenerative spinal disorders and associated chronic back and leg pain is common amongst the general population and its workers. Patients seek surgical care when non-surgical management fails. 

Despite the controversies around evidence-based benefits of spinal surgery for degenerative conditions, the uptake of surgery has increased substantially across the world in the past decades. This could be partly explained by an aging population, the overuse of diagnostic imaging, a lack of consensus on surgery indication, the perceived benefits of advanced medical technology and inadequate research evidence on the effectiveness of surgery. 

Australian data indicates that the use of surgery was disproportionately higher for those with private health insurance, suggesting an influence of financial incentives and issues with equity access to surgical intervention. Similarly, a rise in the rates of surgery and associated costs was also reported among Workers’ Compensation-insured population, with less than 40 per cent returning to work at full capacity.  

Data from public hospitals show variations by the type of surgery performed. These findings were drawn from segmented data sources, hence limiting our ability to comprehensively examine the surgery uptake trajectory and patient outcomes across populations (i.e., public, private and Workers Compensation). 

This program of work will analyse admitted patient data in NSW across 19 years (2001–2020) together with linked records of mortality, MBS and PBS claims data to investigate trends in spinal procedures; health outcomes including readmissions, reoperation and mortality; post-operative use of pain management medications and; community-based health services. 

The findings will shed light to informed decisions around clinical care and public debates that help reform policies and clinical guidelines.