Guest post written by multiple members from the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves. Anthony L. Asher, MD, FAANS, FACS; Erica F. Bisson, MD, MPH, FAANS; Mohammed Bydon MD; Catherine Ann Miller, MD and Praveen V. Mummaneni, MD, FAANS.
The NeuroPoint Alliance (NPA) was established in 2008 by the American Association of Neurological Surgeons (AANS) to collect, analyze and report on nationwide clinical data from neurosurgical practices using online technologies. It is designed to meet the quality care and research needs of:
- Individual neurosurgeons and neurosurgical practices;
- National organizations;
- Health care plans;
- Biomedical industry; and
- Government agencies.
One of the NPA’s seminal projects, the Quality Outcomes Database (QOD), serves as a continuous national clinical registry for neurosurgical procedures and practice patterns. Its primary purpose is to track the quality of surgical care for the most common neurosurgical procedures and provide practice groups and hospitals with an immediate infrastructure for analyzing and reporting the quality of their neurosurgical care.
The goals of QOD are to:
- Establish risk-adjusted national benchmarks for both the cost and quality of common neurosurgical procedures;
- Allow practice groups and hospitals to analyze their individual morbidity and clinical outcomes in real-time;
- Generate both quality and efficiency of neurosurgical procedures;
- Demonstrate the comparative effectiveness of neurosurgical procedures; and
- Facilitate essential multi-center trials and other cooperative clinical studies.
The QOD – Spine registry focuses on common spinal disorders and procedures such as lumbar discectomy, cervical spondylotic myelopathy and spinal deformity. It is the largest spine surgery registry in North America. Since the first enrollment in 2012, it has been generating reliable data for benchmarking, documenting the value of surgical care and quality improvement. More than 82,000 patients from 90 participating sites have been enrolled in the database since its establishment.
The QOD study, “Effectiveness of Fusion for Grade I Spondylolisthesis,” was initiated in response to two recently published articles in the New England Journal of Medicine with differing conclusions on the optimal management in this population. We sought to investigate treatments and outcomes using “real-world” registry data for patients with this spinal disorder. This analysis has provided a wealth of knowledge, resulting in several publications and abstracts, with the data being presented on both national and international platforms. Current analyses include:
- Lumbar Fusion Surgery versus Laminectomy for Spondylolisthesis: Readmission, Reoperation, and Patient Reported Outcomes for Single Level Disease from the QOD Registry;
- Comparison of the Most and Least Satisfied Patients Following Surgery for Degenerative Lumbar Spondylolisthesis Utilizing Data from the National Neurosurgery Quality Outcomes Database;
- Minimally Invasive versus Open Fusion for Grade I Degenerative Lumbar Spondylolisthesis: Analysis Of the Quality Outcomes Database;
- Obesity is Associated with Inferior Patient Reported Outcomes Following Surgery for Degenerative Lumbar Spondylolisthesis: An Analysis of the Quality Outcomes Database; and
- Defining the Minimum Clinically Important Difference for Grade I Degenerative Lumbar Spondylolisthesis: Insights from the Quality Outcomes Database.
Using this validated data, which represents the full spectrum of neurosurgical and orthopedic spine practice throughout the United States, we can develop models that predict which patients will benefit from decompression alone versus fusion. The expected outcomes for these patients also will be better known. Ultimately, this will foster the ability to deliver the right care to the right patient at the right time.
Editor’s Note: We encourage everyone to join the conversation online by using the hashtag #SpineMonth.