Evaluation of spinal interventions in a single doctor private practice in Sweden

Aims To evaluate the effect of spinal interventions following ISIS guidelines [1]. Methods Data from all patients from April 2012 until February 2014 have been registered and followed up after 4-6 months. Patients were mainly referred from surgeons at the regional hospitals. Employment status, medication, VAS, EQ-5D-5L, EQ-VAS and pain reduction were gathered before and at the follow-up. Only patients receiving any kind of treatment were included. Results So far 419/823 patients have been followed-up. Here we present levels of medication and total pain reduction for all patients and, separately, for patients treated with radio frequency facet joint medial branch neurotomy (n = 76). Opioids were reduced from 33% to 26% and no use of analgesics increased from 15% to 31% (p < 0.0159). Opioids in the RF group fell from 31% to 21%, and no use went from 2% to 31%. Of all the patients, 46% had pain reduction >50% and 9% were pain free. In the RF group the figures were 57% and 11%, respectively. No one in the RF group got worse. Conclusion It is important to follow-up your results, even if complete scientific RCT rigour cannot be upheld Our stringent, long-term follow-up can presumably deliver reasonably reliable effect information, a majority of our patients have reduced their medication significantly (p < 0.001) and more than 50% experience a greater than 50% pain reduction, indicating a significant effect.