{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T15:18:55Z","timestamp":1793632735052,"version":"4.5.1"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,6,4]],"date-time":"2023-06-04T00:00:00Z","timestamp":1685836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Spinal disorders are amongst the conditions with the highest burden of disease. To limit the increase of healthcare-related costs in the ageing population, the selection of different types of care for patients with spinal disorders should be optimized. The first step is to investigate the characteristics of these patients and the relationship with treatment. Research Question: The primary aim of this study was to provide insights in the characteristics, symptoms, diagnosis and treatment of patients referred to a specialized spinal health care centre. The secondary aim was to perform an in-depth analysis of resource utilization for a representative subgroup of patients. Methods: This study describes the characteristics of 4855 patients referred to a secondary spine centre. Moreover, an extensive analysis of a representative subgroup of patients (~20%) is performed. Results: The mean age was 58.1, 56% of patients were female, and the mean BMI was 28. In addition, 28% of patients used opioids. Mean self-reported health status was 53.3 (EuroQol 5D Visual Analogue Scale), and pain ranged from 5.8 to 6.7 (Visual Analogue Scale neck\/back\/arm\/leg). Additional imaging was received by 67.7% of patients. Surgical treatment was indicated for 4.9% of patients. The majority (83%) of non-surgically treated patients received out-of-hospital treatment; 25% of patients received no additional imaging or in-hospital treatment. Conclusion: The vast majority of patients received non-surgical treatments. We observed that ~10% of patients did not receive in-hospital imaging or treatment and had acceptable or good questionnaire scores at the time of referral. These findings suggest that there is potential for improvement in efficacy of referral, diagnosis, and treatment. Future studies should aim to develop an evidence base for improved patient selection for clinical pathways. The efficacy of chosen treatments requires investigation of large cohorts.<\/jats:p>","DOI":"10.3390\/jcm12113840","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T02:18:29Z","timestamp":1685931509000},"page":"3840","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Referrals, Symptoms and Treatment of Patients Referred to a Secondary Spine Centre\u2014How Can We Help?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0955-7983","authenticated-orcid":false,"given":"Ruud","family":"Droeghaag","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"},{"name":"CAPHRI School for Public Health and Primary Care, Maastricht University, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Nabben","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"Smeets","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Neurosurgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"van Hemert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narender","family":"van Orshoven","sequence":"additional","affiliation":[{"name":"Department of Neurology Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk","family":"van Santbrink","sequence":"additional","affiliation":[{"name":"CAPHRI School for Public Health and Primary Care, Maastricht University, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Neurosurgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Neurosurgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-5629","authenticated-orcid":false,"given":"Jasper","family":"Most","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"},{"name":"CAPHRI School for Public Health and Primary Care, Maastricht University, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inez","family":"Curfs","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2302","DOI":"10.1016\/S0140-6736(18)30725-6","article-title":"Low back pain: A major global challenge","volume":"391","author":"Clark","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1136\/annrheumdis-2013-204428","article-title":"The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study","volume":"73","author":"Hoy","year":"2014","journal-title":"Ann. Rheum. 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