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. 2013 Apr;22(4):953-74.
doi: 10.1007/s00586-013-2758-9.

Swespine: the Swedish spine register : the 2012 report

Björn Strömqvist  1 , Peter Fritzell, Olle Hägg, Bo Jönsson, Bengt Sandén; Swedish Society of Spinal Surgeons
Affiliations

Swespine: the Swedish spine register : the 2012 report

Björn Strömqvist et al. Eur Spine J. 2013 Apr.

Abstract

Introduction: Swespine, the Swedish National Spine Register, has existed for 20 years and is in general use within the country since over 10 years regarding degenerative lumbar spine disorders. Today there are protocols for registering all disorders of the entire spinal column.

Materials and methods: Patient-based pre- and postoperative questionnaires, completed before surgery and at 1, 2, 5 and 10 years postoperatively. Among patient-based data are VAS pain, ODI, SF-36 and EQ-5D. Postoperatively evaluation of leg and back pain as compared to preoperatively ("global assessment"), overall satisfaction with outcome and working conditions are registered in addition to the same parameters as preoperatively evaluation. A yearly report is produced including an analytic part of a certain topic, in this issue disc prosthesis surgery. More than 75,000 surgically treated patients are registered to date with an increasing number yearly. The present report includes 7,285 patients; 1-, 2- and 5-year follow-up data of previously operated patients are also included for lumbar disorders as well as for disc prosthesis surgery.

Results: For the degenerative lumbar spine disorders (disc herniation, spinal stenosis, spondylolisthesis and DDD) significant improvements are seen in all aspects as exemplified by pronounced improvement regarding EQ-5D and ODI. Results seem to be stable over time. Spinal stenosis is the most common indication for spine surgery. Disc prosthesis surgery yields results on a par with fusion surgery in disc degenerative pain. The utility of spine surgery is well documented by the results.

Conclusion: Results of spine surgery as documented on a national basis can be utilized for quality assurance and quality improvement as well as for research purposes, documenting changes over time and bench marking when introducing new surgical techniques. A basis for international comparisons is also laid.

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Figures

Fig. 1
Fig. 1
Breakdown by diagnosis in the total material 2011, 7,529 patients
Fig. 2
Fig. 2
Distribution by age, disc herniation, n = 2,118
Fig. 3
Fig. 3
Back pain on the VAS preoperatively in patients with disc herniation (%)
Fig. 4
Fig. 4
Leg pain on the VAS preoperatively in patients with disc herniation (%)
Fig. 5
Fig. 5
Distribution by age, central spinal stenosis, n = 3,367 patients
Fig. 6
Fig. 6
Back pain on the VAS preoperatively in patients with central spinal stenosis (%)
Fig. 7
Fig. 7
Leg pain on the VAS preoperatively in patients with central spinal stenosis (%)
Fig. 8
Fig. 8
Distribution by age, lateral spinal stenosis, n = 532
Fig. 9
Fig. 9
Back pain on the VAS preoperatively in patients with lateral spinal stenosis (%)
Fig. 10
Fig. 10
Leg pain on the VAS preoperatively in patients with lateral spinal stenosis (%)
Fig. 11
Fig. 11
Distribution by age, spondylolisthesis, n = 323 patients
Fig. 12
Fig. 12
Back pain on the VAS preoperatively in patients with spondylolisthesis (%)
Fig. 13
Fig. 13
Leg pain on the VAS in patients with spondylolisthesis (%)
Fig. 14
Fig. 14
Distribution by age, DDD, n = 620 patients
Fig. 15
Fig. 15
Back pain on the VAS preoperatively in patients with DDD (%)
Fig. 16
Fig. 16
Leg pain on the VAS preoperatively in patients with DDD (%)
Fig. 17
Fig. 17
Back pain on the VAS preoperatively and 1 year postoperatively in patients operated for lumbar disc herniation in 2010 (%)
Fig. 18
Fig. 18
Leg pain on the VAS preoperatively and 1 year postoperatively in patients operated for lumbar disc herniation in 2010 (%)
Fig. 19
Fig. 19
SF-36 preoperatively and 1 year postoperatively for patients operated for lumbar disc herniation in 2010
Fig. 20
Fig. 20
Back pain on the VAS preoperatively and 1 year postoperatively in patients operated for lumbar central spinal stenosis in 2010 (%)
Fig. 21
Fig. 21
Leg pain on the VAS preoperatively and 1 year postoperatively in patients operated for lumbar central spinal stenosis in 2010 (%)
Fig. 22
Fig. 22
SF-36 preoperatively and 1 year postoperatively for patients operated for lumbar central spinal stenosis 2010
Fig. 23
Fig. 23
Back pain on the VAS preoperatively and 1 year postoperatively in patients operated for lumbar lateral spinal stenosis in 2010 (%)
Fig. 24
Fig. 24
Leg pain on the VAS preoperatively and 1 year postoperatively in patients operated for lumbar lateral spinal stenosis in 2010 (%)
Fig. 25
Fig. 25
SF-36 preoperatively and 1 year postoperatively for patients operated for lumbar lateral spinal stenosis in 2010
Fig. 26
Fig. 26
Back pain on the VAS preoperatively and 1 year postoperatively in patients operated for spondylolisthesis in 2010 (%)
Fig. 27
Fig. 27
Leg pain on the VAS preoperatively and 1 year postoperatively in patients operated for spondylolisthesis in 2010 (%)
Fig. 28
Fig. 28
SF-36 preoperatively and 1 year postoperatively for patients operated for spondylolisthesis in 2010
Fig. 29
Fig. 29
Back pain on the VAS preoperatively and 1 year postoperatively in patients operated for DDD in 2010 (%)
Fig. 30
Fig. 30
Leg pain on the VAS preoperatively and 1 year postoperatively in patients operated for DDD in 2010 (%)
Fig. 31
Fig. 31
SF-36 preoperatively and 1 year postoperatively for patients operated for DDD in 2010
Fig. 32
Fig. 32
ODI score inclusive of before and one year after lumbar spine surgery, related to diagnosis, for patients operated in 2010 (mean ± CI)
Fig. 33
Fig. 33
Quality of life preoperatively, 1 and 2 years postoperatively, as measured by EQ-5D. LDH lumbar disc herniation, CSS central spinal stenosis, LSS lateral spinal stenosis, Spondy spondylolisthesis, DDD degenerative disc disease
Fig. 34
Fig. 34
Quality of life preoperatively, 1, 2 and 5 years postoperatively, as measured by EQ-5D
Fig. 35
Fig. 35
Number of disc replacement procedures annually, 2003–2011
Fig. 36
Fig. 36
Improvement of back pain as measured by Global Assessment
Fig. 37
Fig. 37
Number of patients entered in the register for degenerative disorders of the lumbar spine 1999–2011
Fig. 38
Fig. 38
Current follow-up rate
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References

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    1. Strömqvist B, Jönsson B. Det nationella registret blir alltmer fullständigt. Dagens Medicin Nr. 2000;20:55.

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