{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:25Z","timestamp":1787025745124,"version":"build-2736575974"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,12]]},"abstract":"\n OBJECT<\/jats:title>\n Given the scrutiny of spine surgery by policy makers, spine surgeons are motivated to demonstrate and improve outcomes, by determining which patients will and will not benefit from surgery, and to reduce costs, often by reducing complications. Insurers are similarly motivated. In 2013, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) established the Michigan Spine Surgery Improvement Collaborative (MSSIC) as a Collaborative Quality Initiative (CQI). MSSIC is one of the newest of 21 other CQIs that have significantly improved\u2014and continue to improve\u2014the quality of patient care throughout the state of Michigan.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n MSSIC focuses on lumbar and cervical spine surgery, specifically indications such as stenosis, disk herniation, and degenerative disease. Surgery for tumors, traumatic fractures, deformity, scoliosis, and acute spinal cord injury are currently not within the scope of MSSIC. Starting in 2014, MSSIC consisted of 7 hospitals and in 2015 included another 15 hospitals, for a total of 22 hospitals statewide. A standardized data set is obtained by data abstractors, who are funded by BCBSM\/BCN. Variables of interest include indications for surgery, baseline patient-reported outcome measures, and medical history. These are obtained within 30 days of surgery. Outcome instruments used include the EQ-5D general health state score (0 being worst and 100 being the best health one can imagine) and EQ-5D-3 L. For patients undergoing lumbar surgery, a 0 to 10 numeric rating scale for leg and back pain and the Oswestry Disability Index for back pain are collected. For patients undergoing cervical surgery, a 0 to 10 numeric rating scale for arm and neck pain, Neck Disability Index, and the modified Japanese Orthopaedic Association score are collected. Surgical details, postoperative hospital course, and patient-reported outcome measures are collected at 90-day, 1-year, and 2-year intervals.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n As of July 1, 2015, a total of 6397 cases have been entered into the registry. This number reflects 4824 eligible cases with confirmed surgery dates. Of these 4824 eligible cases, 3338 cases went beyond the 120-day window and were considered eligible for the extraction of surgical details, 90-day outcomes, and adverse events. Among these 3338 patients, there are a total of 2469 lumbar cases, 862 cervical cases, and 7 combined procedures that were entered into the registry.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In addition to functioning as a registry, MSSIC is also meant to be a platform for quality improvement with the potential for future initiatives and best practices to be implemented statewide in order to improve quality and lower costs. With its current rate of recruitment and expansion, MSSIC will provide a robust platform as a regional prospective registry. Its unique funding model, which is supported by BCBSM\/BCN, will help ensure its longevity and viability, as has been observed in other CQIs that have been active for several years.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2015.10.focus15370","type":"journal-article","created":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T03:37:25Z","timestamp":1448941045000},"page":"E7","source":"Crossref","is-referenced-by-count":44,"title":["The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative"],"prefix":"10.3171","volume":"39","author":[{"given":"Victor","family":"Chang","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Schwalb","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Center for Health Policy and Health Services Research; and"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Nerenz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Center for Health Policy and Health Services Research; and"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Pietrantoni","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Jones","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Jankowski","sequence":"additional","affiliation":[{"name":"Public Health Sciences, and"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Oja-Tebbe","sequence":"additional","affiliation":[{"name":"Public Health Sciences, and"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Bartol","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"},{"name":"Orthopedics;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muwaffak","family":"Abdulhak","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"MSSIC Coordinating Center, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"22 Suppl 1","key":"b1-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"S136","article-title":"Clinical registries and evidence-based care pathways: raising the bar for meaningful measurement and delivery of value-based care","volume":"39","author":"Asher","year":"2014"},{"issue":"1","key":"b2-focus15370","series-title":"Neurosurg Focus","first-page":"E2","article-title":"The National Neurosurgery Quality and Outcomes Database and NeuroPoint Alliance: rationale, development, and implementation","volume":"34","author":"Asher","year":"2013"},{"issue":"22 Suppl 1","key":"b3-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"S106","article-title":"The National Neurosurgery Quality and Outcomes Database (N2QOD): a collaborative North American outcomes registry to advance value-based spine care","volume":"39","author":"Asher","year":"2014"},{"key":"b4-focus15370","series-title":"J Thromb Thrombolysis","first-page":"274","article-title":"Venous thromboembolism: a collaborative quality improvement model for practitioners, hospitals, and insurers","volume":"33","author":"Barnes","year":"2012"},{"key":"b5-focus15370","series-title":"J Spinal Disord","first-page":"286","article-title":"Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy","volume":"4","author":"Benzel","year":"1991"},{"key":"b6-focus15370","series-title":"N Engl J Med","first-page":"864","article-title":"Strategies for improving surgical quality\u2014should payers reward excellence or effort?","volume":"354","author":"Birkmeyer","year":"2006"},{"key":"b7-focus15370","series-title":"JAMA","first-page":"435","article-title":"Hospital complication rates with bariatric surgery in Michigan","volume":"304","author":"Birkmeyer","year":"2010"},{"key":"b8-focus15370","series-title":"Surgery","first-page":"815","article-title":"Partnering with payers to improve surgical quality: the Michigan plan","volume":"138","author":"Birkmeyer","year":"2005"},{"key":"b9-focus15370","series-title":"Bone Joint J","first-page":"871","article-title":"Should we all go to the PROM? 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itself?","volume":"246","author":"Englesbe","year":"2007"},{"key":"b14-focus15370","series-title":"Orthop Res Rev","first-page":"47","article-title":"Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) as a model for regional registries in the United States","volume":"7","author":"Hughes","year":"2015"},{"key":"b15-focus15370","series-title":"J Bone Joint Surg Am","first-page":"752","article-title":"Relationship between rates and outcomes of operative treatment for lumbar disc herniation and spinal stenosis","volume":"81","author":"Keller","year":"1999"},{"key":"b16-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"63","article-title":"Long-term outcomes of lumbar spinal stenosis: eight-year results of the Spine Patient Outcomes Research Trial (SPORT)","volume":"40","author":"Lurie","year":"2015"},{"key":"b17-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"3","article-title":"Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial","volume":"39","author":"Lurie","year":"2014"},{"issue":"22 Suppl 1","key":"b18-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"S117","article-title":"Role of prospective registries in defining the value and effectiveness of spine care","volume":"39","author":"McGirt","year":"2014"},{"issue":"1","key":"b19-focus15370","series-title":"Neurosurg Focus","first-page":"E6","article-title":"The National Neurosurgery Quality and Outcomes Database (N2QOD): general overview and pilot-year project description","volume":"34","author":"McGirt","year":"2013"},{"key":"b20-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"439","article-title":"Does multilevel lumbar stenosis lead to poorer outcomes?: a subanalysis of the Spine Patient Outcomes Research Trial (SPORT) lumbar stenosis study","volume":"35","author":"Park","year":"2010"},{"key":"b21-focus15370","series-title":"Health Aff 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herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort","volume":"296","author":"Weinstein","year":"2006"},{"key":"b26-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"2789","article-title":"Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT)","volume":"33","author":"Weinstein","year":"2008"},{"key":"b27-focus15370","series-title":"J Bone Joint Surg Am","first-page":"1295","article-title":"Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts","volume":"91","author":"Weinstein","year":"2009"},{"key":"b28-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"1329","article-title":"Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research 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The first two years of the British Spine Registry","volume":"97-B","author":"Breakwell","year":"2015"},{"key":"b10-focus15370","series-title":"Surgery","first-page":"635","article-title":"Improving breast cancer care through a regional quality collaborative","volume":"150","author":"Breslin","year":"2011"},{"key":"b11-focus15370","series-title":"J Am Coll Surg","first-page":"141","article-title":"Quality improvement is local","volume":"209","author":"Campbell","year":"2009"},{"key":"b12-focus15370","series-title":"Arch Surg","first-page":"985","article-title":"Accelerating the pace of surgical quality improvement: the power of hospital collaboration","volume":"145","author":"Campbell","year":"2010"},{"key":"b13-focus15370","series-title":"Ann Surg","first-page":"1100","article-title":"The Michigan surgical quality collaborative: will a statewide quality improvement initiative pay for 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herniation: eight-year results for the spine patient outcomes research trial","volume":"39","author":"Lurie","year":"2014"},{"issue":"22 Suppl 1","key":"b18-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"S117","article-title":"Role of prospective registries in defining the value and effectiveness of spine care","volume":"39","author":"McGirt","year":"2014"},{"issue":"1","key":"b19-focus15370","series-title":"Neurosurg Focus","first-page":"E6","article-title":"The National Neurosurgery Quality and Outcomes Database (N2QOD): general overview and pilot-year project description","volume":"34","author":"McGirt","year":"2013"},{"key":"b20-focus15370","series-title":"Spine (Phila Pa 1976)","first-page":"439","article-title":"Does multilevel lumbar stenosis lead to poorer outcomes?: a subanalysis of the Spine Patient Outcomes Research Trial (SPORT) lumbar stenosis study","volume":"35","author":"Park","year":"2010"},{"key":"b21-focus15370","series-title":"Health Aff 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