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British Spinal Registry B ritish Association of Spine Surgeons Middlesbrough February 2007 John O’Dowd Nicky Courtier

British Spinal Registry B ritish Association of Spine Surgeons Middlesbrough February 2007 John O’Dowd Nicky Courtier. Low back data set. 538 cases Mean age 52 Male/female 45/55 % Pain Back 11.3% Leg 16.6% Back and leg 72.1%. Low back data set. 538 cases Diagnosis

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British Spinal Registry B ritish Association of Spine Surgeons Middlesbrough February 2007 John O’Dowd Nicky Courtier

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  1. British Spinal RegistryBritish Association of Spine SurgeonsMiddlesbroughFebruary 2007John O’DowdNicky Courtier

  2. Low back data set • 538 cases • Mean age 52 • Male/female 45/55 % • Pain • Back 11.3% • Leg 16.6% • Back and leg 72.1%

  3. Low back data set • 538 cases • Diagnosis • Disc herniation 39.1% • Stenosis 36.3% • Degenerative spondylolisthesis 14.6% • Degenerative scoliosis 1.2% • Previous decompression 6.1% • Previous fusion 2.5%

  4. Low back data set • Procedure • Discectomy 37.9% • Segmental decompression 46% • Foraminotomy 14% • Laminectomy 10.7% • Posterolateral fusion 20% • Anterior fusion 1.6% • Circumferential fusion 0.4% • Stabilisation 17.86% • Arthroplasty 2.5% • Revision decompression 3.3%

  5. Low back data set • Implant • None 53.4% • Translaminar screws 0.4% • Pedicle screws 24.1% • DYNESYS 14.6% • Wallis 4.4% • Cage 2.4% • Disc arthoplasty 3%

  6. Low back data set • Complications % if full reporting • Nerve root injury n=2 0.4% • Cauda equina n=0 0 • Dural tear n=20 3.7% • CSF leak n=10 1.8% • Infection n=6 1.1% • Early revision n= 4 0.7%

  7. SINGLE LEVEL LUMBAR DISCECTOMY • Total cases 106 • Age 43.36 M/F 62%/38% • Level • L3/4 3.8% • L4.5 38.1% • L5/S1 58.1% • Side • Left 49% • Right 51%

  8. BASS Audit • Decompression • Yes 91% • No 9% • Microscope • Yes 3% • No 97% • Intraoperative xray to confirm level • Yes 29.6% • No 70.4%

  9. BASS Audit • Disc • Sequestered 12.6% • Extruded 17.9% • Contained 69.5% • Pre op • ODI average 49.3% ( n=23) • VAS leg 6.2 (n=25) • VAS back 5.6 (n=21)

  10. BASS Audit • Dural tear • Yes 2.9% • No 97.1% • Arachnoid intact • Yes 42.9% • No 57.1% • Free CSF • Yes 37.5% • No 62.5%

  11. BASS Audit • Tear repaired • Yes 20% (n=1) • No 80% (n=4) • Suture • Yes 40% (n=2) • No 60% (n=3) • Patch • Yes 20% (n=1) • No 80% (n=4) • Drain • Yes 80% (n=4) • No 20% (n=1)

  12. BASS Audit • Vascular injury 0 • Blood loss > 250 mls 0 • Post op complications 2.4% (n=2) • Increased neurological deficit n=1 • Recurrence < 3months n=1 • Infection n=1 (1.3%) • Reoperation all causes n=0

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