133. Patient-reported outcomes following surgery for lumbar disc herniation: comparison of a universal and multitier health care system

Abstract

BACKGROUND CONTEXT Canada has a government-fundeduniversal health care system and access to specialist care requires a referral by general practitioners. In contrast, the United States utilizes a blended public and private payer system where insured patients can directly access specialists. PURPOSE The purpose of this study is to investigate whether clinical outcomes differ between those surgically treated for lumbar disc herniation in Canada as compared to the United States. STUDY DESIGN/SETTING A retrospective analysis of the surgical lumbar disc herniation patients enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective multicenter registry and the Spine Patients Outcome Research Trial (SPORT) study. PATIENT SAMPLE Consecutive surgical lumbar disc herniation patients enrolled in the CSORN registry and the SPORT trial. OUTCOME MEASURES Baseline demographics, and spine-related patient-reported outcomes (PROs), including disatisfaction, were compared at three months and one year postoperatively. METHODS A retrospective analysis of surgical lumbar disc herniation patients enrolled in the CSORN registry and the SPORT trial. RESULTS The CSORN cohort consisted of 703 patients and the SPORT cohort included 573 patients. The rate of females in each cohort was similar (47.2% vs 46.4%, p=0.78); however, patients in the CSORN cohort were older (46.2 ±13.2 vs 41.6 ±10.9, p CONCLUSIONS Patients undergoing surgical treatment for lumbar disc herniation in Canada (CSORN cohort) reported higher rates of satisfaction at three months and one year postoperatively compared to the United States cohort (SPORT) despite having longer durations of symptoms prior to surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.