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Does Spine Surgery Clinic Referral Lead to Spine Surgery? A Comparison of Spine Specialty Physiatrists in a Multidisciplinary Spine Center versus Other Providers

Benjamin D. Washburn, MD (University of Missouri-Columbia PM&R Program, Columbia, MO, United States); Mark Drymalski, MD; Mohammad Agha, MD, MHA; Elena Randazzo

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Friday, November 15, 2019

Session Title: Musculoskeletal and Sports Medicine Case Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 3

Disclosures: Benjamin D. Washburn, MD: Nothing to disclose

Objective: To determine if outpatient spine surgery referrals in a multidisciplinary spine center were more likely to be surgical candidates and undergo spine surgery when referred by a spine specialist physiatrist compared to other providers.

Design: Retrospective medical record review.

Setting: Multidisciplinary comprehensive spine center within a single academic medical center.

Participants: Three hundred ninety-four patients.

Interventions: Not applicable.

Main Outcome Measures: Rates of surgical candidacy (as deemed by the spine surgeon) and rates of patients undergoing spine surgery.

Results: We identified 394 new patient referrals to spine surgery clinic between February 2016 and January 2017. There were 187 spine surgical referrals from spine specialty physiatrists. Sixty-five percent (65%) of those were offered spine surgery and 42% underwent surgery. There were 207 referrals combined between primary care providers (PCP), orthopedic spine nurse practitioners (NP), non-spine orthopedic surgeons, and other University specialist physicians. Twenty-six percent (26%) of the PCP referrals were offered spine surgery and 21% underwent surgery; 46% of the orthopedic spine NP referrals were offered spine surgery and 34% underwent surgery; 48% of the non-spine orthopedic surgeon referrals were offered spine surgery and 33% underwent surgery; and 35% of the other University specialists physician referrals were offered spine surgery and 30% underwent surgery.

Conclusions: Spine surgery referrals from physiatrists within the multidisciplinary spine center yielded a greater proportion of both surgical candidates and patients who underwent surgery compared to all other referral types. This higher percentage of appropriate spine surgery referrals may result in reduced treatment time and reduced costs via increased spine surgery clinic efficiency and decreased utilization of healthcare resources. In conclusion, these findings demonstrate potential benefits in a physiatry-led multidisciplinary pathway to provide care for patients within a comprehensive spine center.

Level of Evidence: Level V

To cite this abstract in AMA style:

Washburn BD, Drymalski M, Agha M, Randazzo E. Does Spine Surgery Clinic Referral Lead to Spine Surgery? A Comparison of Spine Specialty Physiatrists in a Multidisciplinary Spine Center versus Other Providers [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/does-spine-surgery-clinic-referral-lead-to-spine-surgery-a-comparison-of-spine-specialty-physiatrists-in-a-multidisciplinary-spine-center-versus-other-providers/. Accessed May 22, 2025.
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