Wait times for degenerative lumbar spine consultation and surgery: a repeated cross-sectional analysis of the Canadian Spine Outcomes and Research Network.

Abstract

Background: Lumbar spine pathology is an increasingly common condition that often requires timely access to specialist spinal surgeons, but prolonged wait times for specialist care are a serious problem in Canada. We sought to compare contemporaneous wait times for spinal surgical consultation across Canada.

Methods: In this observational study, we used data from the Canadian Spine Outcome and Research Network from between 2015 and 2019. We defined wait times for spinal surgical care as the time between the date of primary care referral and surgery. We used simple linear regression to determine the average change in wait time per year. We calculated the percentage of patients meeting wait time targets for surgical intervention, set as the Canadian Institute for Health Information benchmark (< 182 days).

Results: We included 3963 surgical patients. The median wait was 92 (interquartile range [IQR] 35 to 221) days between referral and consultation and 92 (IQR 41 to 165) days between booking and surgery, with a cumulative median wait time of 272 (IQR 137 to 483) days between referral and surgery. The cumulative wait time increased gradually over the 5-year study period, with an average increase of 25 days per year. The percentage of participants who did not meet the wait time benchmark was almost 30% in 2019.

Conclusion: Patients requiring operative spinal care waited almost 1 year from primary care referral to surgical management for disabling lumbar conditions. Evidence-based strategies are needed to reduce wait times and improve access to care.