NDLI: Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study

Content Provider	Springer Nature : BioMed Central
Author	Lenza, Mario Buchbinder, Rachelle Staples, Margaret P. dos Santos, Oscar F.P. Brandt, Reynaldo A. Lottenberg, Claudio L. Cendoroglo, Miguel Ferretti, Mario
Abstract	Background Second opinions may improve quality of patient care. The primary objective of this study was to determine the concordance between first and second diagnoses and opinions regarding need for spinal surgery among patients with back or neck pain that have been recommended spinal surgery. Methods We performed a prospective observational study of patients who had been recommended for spinal surgery and received a second opinion between May 2011 and May 2012 at the Hospital Israelita Albert Einstein on the advice of their health insurance company. A physiatrist and orthopaedic surgeon independently performed the second assessment. If both agreed surgery was indicated, or consensus could not be reached, participants attended a spine review panel for a final recommendation. Descriptive analyses compared diagnoses and management plans of the first and second opinions. Results Of 544 referred patients, 16 (2.9%) did not meet inclusion criteria, 43 (7.9%) refused participation and 485 were included. Diagnoses differed from the first opinion for 290 (59.8%). Diagnoses of cervical and lumbar radiculopathy were concordant in 36/99 (36.4%) and 116/234 (49.6%) respectively. The second opinion was for conservative treatment for 168 (34.6%) participants, 27 (5.6%) were not considered to have a spine condition, and 290 (59.8%) were referred to the review board. 60 participants did not attend the board review and therefore did not receive a final recommendation. Board review was conservative treatment for an additional 67 participants, 20 were not considered to have a spine condition and 143 participants were recommended surgery. Overall, 33.6% received a final opinion of surgery (143/425) although only 66 (15.5%) received the same surgical recommendation, 235 (55.3%) were advised to have conservative treatment, and 47 (11.1%) were not considered to have a spinal diagnosis. Conclusions We found a large discordance between first and second opinions regarding diagnosis and need for spinal surgery. This suggests that obtaining a second opinion could reduce potentially unnecessary surgery. Trial registration Current Controlled Trials ISRCTN07143259 . Registered 21 November 2011.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-017-1712-0.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-017-1712-0
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2017-08-17
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Spine [MeSH] Back pain [MeSH] Surgical procedures Operative [MeSH] Referral and consultation [MeSH] Unnecessary procedures [MeSH]
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Complications of injections in conservative treatment of degenerative spine disease: a prospective unicentric study

A prospective observational study on trajectories and prognostic factors of mid back pain

Walking speed is associated with postoperative pain catastrophizing in patients with lumbar spinal stenosis: a prospective observational study

Improving consultations for persistent musculoskeletal low back pain in orthopaedic spine settings: an intervention development

Association between back muscle degeneration and spinal-pelvic parameters in patients with degenerative spinal kyphosis

The Prevalence of low back pain in Africa: a systematic review

The effect of required physiatrist consultation on surgery rates for back pain.

Brief pain re-assessment provided more accurate prognosis than baseline information for low-back or shoulder pain

Spinal fusion surgery use among adults with low back pain enrolled in a digital musculoskeletal program: an observational study

Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study

Similar Documents

Complications of injections in conservative treatment of degenerative spine disease: a prospective unicentric study

A prospective observational study on trajectories and prognostic factors of mid back pain

Walking speed is associated with postoperative pain catastrophizing in patients with lumbar spinal stenosis: a prospective observational study

Improving consultations for persistent musculoskeletal low back pain in orthopaedic spine settings: an intervention development

Association between back muscle degeneration and spinal-pelvic parameters in patients with degenerative spinal kyphosis

The Prevalence of low back pain in Africa: a systematic review

The effect of required physiatrist consultation on surgery rates for back pain.

Brief pain re-assessment provided more accurate prognosis than baseline information for low-back or shoulder pain

Spinal fusion surgery use among adults with low back pain enrolled in a digital musculoskeletal program: an observational study

Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study