{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T02:21:27Z","timestamp":1785291687913,"version":"3.55.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,11]],"date-time":"2021-09-11T00:00:00Z","timestamp":1631318400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,11]],"date-time":"2021-09-11T00:00:00Z","timestamp":1631318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012049","name":"State Insurance Regulatory Authority","doi-asserted-by":"publisher","award":["Spine surgery audit"],"award-info":[{"award-number":["Spine surgery audit"]}],"id":[{"id":"10.13039\/501100012049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012049","name":"State Insurance Regulatory Authority","doi-asserted-by":"publisher","award":["Spine surgery audit"],"award-info":[{"award-number":["Spine surgery audit"]}],"id":[{"id":"10.13039\/501100012049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Internationally, elective spinal surgery rates in workers\u2019 compensation populations are high, as are reoperation rates, while return-to-work rates following spinal surgery are low. Little information is available from Australia. The aim of this study was to describe the rates, costs, return to work and reoperation following elective spinal surgery in the workers\u2019 compensation population in New South Wales (NSW), Australia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective cohort study used administrative data from the State Insurance Regulatory Authority, the government organisation responsible for regulating and administering workers\u2019 compensation insurance in NSW. These data cover all workers\u2019 compensation-insured workers in New South Wales (over 3\u00a0million workers\/year). We identified a cohort of insured workers who underwent elective spinal surgery (fusion or decompression) between January 1, 2010 and December 31, 2018. People who underwent surgery for spinal fracture or dislocation, or who had sustained a traumatic brain injury were excluded. The main outcome measures were annual spinal surgery rates, cost of the surgical episode, cumulative costs (surgical, hospital, medical and physical therapy) to 2 years post-surgery, and reoperation and return-to-work rates 2 years post-surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There were 9343 eligible claims (39.1\u2009% fusion; 59.9\u2009% decompression); claimants were predominantly male (75\u2009%) with a mean age of 43 (range 18 to 75) years. Spinal surgery rates ranged from 15 to 29 surgeries per 100,000 workers per year, fell from 2011-12 to 2014-15 and rose thereafter. The average cost in Australian dollars for a surgical episode was $46,000 for a spinal fusion and $20,000 for a decompression. Two years post-fusion, only 19\u2009% of people had returned to work at full capacity; 39\u2009% after decompression. Nineteen percent of patients underwent additional spinal surgery within 2 years of the index surgery, to a maximum of 5 additional surgeries.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Rates of workers\u2019 compensation-funded spinal surgery did not rise significantly during the study period, but reoperation rates are high and return-to-work rates are low in this population at 2 years post- surgery. In the context of the poor evidence base supporting lumbar fusion surgery, the high cost, increasing rates, and the increased likelihood of poor outcomes in the workers\u2019 compensation population, we question the value of this procedure in this setting.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-021-06900-8","type":"journal-article","created":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T13:03:46Z","timestamp":1631451826000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Rates, costs, return to work and reoperation following spinal surgery in a workers\u2019 compensation cohort in New South Wales, 2010\u20132018: a cohort study using administrative data"],"prefix":"10.1186","volume":"21","author":[{"given":"AM","family":"Lewin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Fearnside","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Kuru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BP","family":"Jonker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JM","family":"Naylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Sheridan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IA","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,11]]},"reference":[{"key":"6900_CR1","doi-asserted-by":"crossref","unstructured":"Harris IA, Traeger A, Stanford R, Maher CG, Buchbinder R. Lumbar spine fusion: what is the evidence?\u00a0Intern Med J.\u00a02018;48(12):1430\u20134.","DOI":"10.1111\/imj.14120"},{"issue":"9","key":"6900_CR2","first-page":"S95-S103","volume":"161","author":"IA Harris","year":"2020","unstructured":"Harris IA, Sidhu B, Mittal R, Adie S: Surgery for chronic musculoskeletal pain: the question of evidence. Pain 2020, 161(9):S95-S103.","journal-title":"Pain"},{"key":"6900_CR3","unstructured":"Australian Commission on Safety and Quality in Health Care: Prioritised list of clinical domains for clinical quality registry development. In., Final Report edn. Sydney, Australia; 2016."},{"key":"6900_CR4","doi-asserted-by":"crossref","unstructured":"Provaggi E, Capelli C, Leong JJH, Kalaskar DM: A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery. Medicine.\u00a02018;97(26).","DOI":"10.1097\/MD.0000000000011169"},{"key":"6900_CR5","doi-asserted-by":"crossref","unstructured":"Grotle M, Smastuen MC, Fjeld O, Grovle L, Helgeland J, Storheim K, Solberg TK, Zwart JA. Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway. BMJ Open. 2019;9(8):e028743.","DOI":"10.1136\/bmjopen-2018-028743"},{"key":"6900_CR6","doi-asserted-by":"crossref","unstructured":"Harris IA, Dao AT. Trends of spinal fusion surgery in Australia: 1997 to 2006.\u00a0ANZ J Surg.\u00a02009;79(11):783\u20138.","DOI":"10.1111\/j.1445-2197.2009.05095.x"},{"issue":"1","key":"6900_CR7","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s00776-014-0656-6","volume":"20","author":"Y Imajo","year":"2015","unstructured":"Imajo Y, Taguchi T, Yone K, Okawa A, Otani K, Ogata T, Ozawa H, Shimada Y, Neo M, Iguchi T: Japanese 2011 nationwide survey on complications from spine surgery. 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All methods were performed in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Rob Kuru is a\u00a0listed assessor of permanent impairment with the State Insurance Regulatory Authority (SIRA) and Vice President of the Spine Society of Australia.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"955"}}