DOI: 10.5061/dryad.7p65c8p4
title: Data from: Clinical decision making in spinal fusion for chronic low back pain. Results of a nationwide survey among spine surgeons

description: OBJECTIVES: To assess the use of prognostic patient factors and predictive
 tests in clinical decision making for spinal fusion in patients with
 chronic low back pain. DESIGN AND SETTING: Nationwide survey among spine
 surgeons. PARTICIPANTS: Surgeon members of the Dutch Spine Society were
 questioned on their treatment strategy for chronic low back pain. PRIMARY
 AND SECONDARY OUTCOME MEASURES: The surgeons’ opinion on the use of
 prognostic factors and tests for patient selection were addressed, and the
 degree of uniformity was assessed. In addition, the influence of surgeon
 specific factors, such as clinical experience and training, was
 determined. RESULTS: The comments from 62 surgeons (70% response rate)
 were analysed. Forty-four surgeons (71%) had extensive clinical
 experience. There was a statistically significant lack of uniformity of
 opinion in 7 of the 11 items on prognostic factors and 8 of the 11 items
 on predictive tests, respectively. Imaging was valued much higher than
 predictive tests, psychological screening, or patient preferences (all
 p&lt;0.01). Apart from the use of discography and long multi-segment
 fusions, differences in training or clinical experience did not appear to
 be of significant influence on treatment strategy. CONCLUSIONS: The
 present survey showed a lack of consensus among spine surgeons on the use
 of predictive tests for patient selection. Prognostic patient factors were
 not consistently incorporated in their treatment strategy. Clinical
 decision making for spinal fusion to treat chronic low back pain does not
 have a uniform evidence base in practice. Future research should focus on
 identifying subgroups of patients for whom spinal fusion is an effective
 treatment. Only a reliable prediction of surgical outcome, combined with
 the implementation of individual patient factors, may enable the
 instalment of consensus guidelines in surgical decision making for chronic
 low back pain.
description: Orthopedie_surveyNLThe numbers 1 to 25 in the upper row correspond to the 25 questions in the survey that are present in the appendix of the BMJOpen manuscript. The colon under 1A is not relevant as it concerns nonsurgeon members of the Dutch Spine Society who were excluded from analysis as they do not perform spinal fusion in practice. Further, question 4 had 5 options and for analysis was divided in 5 subquestions which could be answered with yes or no (1 or 0). This data file contains the answers of all members of the Dutch Spine Society. To get the right impression on decision making for spinal fusion in low back pain patients, we only analysed the answers from surgeons who do this kind of surgery, so answer to question 1 should be 1 (neurosurgeon) or 2 (orthopedic surgeon), other members were excluded. In addition, question 5 (how many fusions per year for low back pain?) should be answer 2,3,4 or 5. Those who answered a 1 (0 fusions for back pain per year) were excluded from analysis. Thus, excluding those who answered with a 3 to question 1 or with a 1 to question 5 were excluded, which will leave you with a database of 62 respondents which was used for analysis in our paper.