RESULTS OF THE BRITISH NATIONAL SPINAL REGISTRY; THE FIRST THREE YEARS

Abstract

Introduction: This is a report on results from the first three years of the British Spinal Registry

Background: The British Scoliosis Society supported a web based scoliosis registry in 2003. At the Britspine meeting in 2004 all four British spine societies (BSS, BASS, BCSS, SBPR) agreed to expand this to include all spinal surgical procedures in the United Kingdom. An extensive marketing and promotional campaign was targeted at all members of the four societies, and online and telephone support was provided.

Aims: To report on the clinical results from the first three years registry activity

Methods: The British Spinal Registry is a web based out-come tool, collecting basic demographic and outcome data on spinal surgical procedures in the UK. Over three years from November 2004, 1410 patient data sets were entered. The activity analysis is party carried out using the online diagnostics that are part of the web based software tool, and partly with downloaded data.

Results: 73 surgeons from 55 centres entered patient data on 1410 surgical episodes between November 2004 and December 2007. The number of patients entered per year has declined marginally, with 540 patients in the first year, 454 in the second and 416 in the third. The majority of cases entered have a low back diagnosis (842) of whom 106 were part of a BASS audit on discectomy. Of the low back cases 40% had disc herniation and 7.4% had previous surgery. The complications included dural tear (3.7%), nerve root injury (0.4%) and infection (1.1%). The BASS study showed that 70% of UK surgeons were not using intraoperative radiographic localisation of surgical level. There were 448 deformity cases, and of these 223 were idiopathic scoliosis, 49 neuromuscular and 20 congenital. 57% had posterior surgery, 20% anterior and 23% combined. There were no intraoperative deaths, no complete spinal cord injuries, 4 partial spinal cord injuries (0.9%), 6 deep infections (1.3%) and 14 implant revisions (3.1%).

Conclusion: The initial clinical results from the British Spinal Registry support the hypothesis that such registries can produce useful audit data. There is no other record nationally of number and type of procedures in spinal surgery in the UK. The complication rates are similar to those reported elsewhere and provide an opportunity for benchmarking and for comparative personal and centre audit. The uptake and usage rates however are low and would not allow scientifically valid clinical results to be reported.