Shaping conservative spinal services with the Spine Tango Registry
This study reports the results of a registry data collection project within a secondary care spinal osteopathy service.
Clinical and demographic data were collected using the Spine Tango Conservative registry data collection tool. Outcomes were assessed using the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Neck Disability Index (NDI), COMI Low Back Conservative (COMI-LBC), COMI Neck Conservative (COMI-NC) and EQ5D. Global treatment outcome (GTO), satisfaction with care and therapeutic complications were reported using the Spine Tango Patient Self Assessment form (STPSA). The correlation of GTO and PROM change scores was analysed using Spearman’s rank correlation coefficient.
262 patients presented during the study period. 100% of patients had chronic spinal pain and 98.8% had previously received other interventions for the same episode. Mean (standard deviation) improvements by PROM: NPRS low back 2.1 (2.5); NPRS neck 2.3 (2.3); COMI-LBC 2.1 (2.2); COMI-NC 2.0 (1.7); ODI 10.5 (12.1); NDI 14.5 (12.2); EQ5D 0.2 (0.3). 83.2% of patients reported that osteopathy had ‘helped a lot’ or ‘helped’. 96.2% of patients were ‘very satisfied’ or ‘satisfied’ with care. There were no serious therapeutic complications.
The secondary care spinal osteopathy service demonstrated high satisfaction, few therapeutic complications and positive outcomes on all PROMs. Registry participation has facilitated robust clinical governance and the data support the use of osteopaths to deliver a conservative spinal service in this setting. Registry data collection is a significant administrative and clinical task which should be structured to minimise burden on patients and resources.
KeywordsRegistries Patient outcome assessment Data collection Clinical governance Osteopathy
Compliance with ethical standards
Conflict of interest
None of the authors has any potential conflict of interest.
- 1.Kay TM, Myers AM, Huiljbregts MP (2001) How far have we come since 1992? A comparative survey of physiotherapists’ use of outcome measures. Physiother Can 53(4):268–275Google Scholar
- 2.Department of Health (2000) The NHS Plan. A plan for investment. A plan for reform. The Stationery Office Ltd, LondonGoogle Scholar
- 3.Department of Health (2010) Equity and excellence: liberating the NHS. The Stationery Office Ltd., London (ISBN 978010178812) Google Scholar
- 9.Last A, Hulbert K (2009) Chronic low back pain: evaluation and management. Am Fam Phys 79(12):1067–1074Google Scholar
- 13.O’Keeffe M, Purtill H, Kennedy N, Conneely M, Hurley J, O’Sullivan P, Dankaerts W, O’Sullivan K (2016) Comparative effectiveness of conservative interventions for nonspecific chronic spinal pain: physical, behavioral/psychologically informed, or combined? A systematic review and meta-analysis. J Pain 17(7):755–774. https://doi.org/10.1016/j.jpain.2016.01.473 CrossRefPubMedGoogle Scholar
- 20.Breakwell LM (2013) Understanding the need for spinal registries: Lee Breakwell reviews the importance of registries in spinal research and explains why the British Association of Spinal Surgeons (BASS) has decided to set up its own registry. Eur Spine J 22(Suppl 1):S5–S6. https://doi.org/10.1007/s00586-013-2666-z CrossRefPubMedGoogle Scholar
- 23.National Spinal Taskforce (2013) Commissioning spinal services—getting the service back on track: a guide for commissioners of spinal services. http://www.nationalspinaltaskforce.co.uk/pdfs/NHSSpinalReport_vis7%2030.01.13.pdf. Accessed 12 Dec 2016
- 29.Vernon H, Mior S (1991) The Neck Disability Index: a study of reliability and validity. J Manip Physiol Ther 14(7):409–415Google Scholar
- 32.Zweig T, Enke J, Mannion AF, Sobottke R, Mellow M, Freeman B, Aghayev E (2017) Is the duration of pre-operative conservative treatment associated with the clinical outcome following surgical decompression for lumbar spinal stenosis? A study based on the Spine Tango Registry. Eur Spine J 26(2):488–500CrossRefPubMedGoogle Scholar
- 37.Mannion AF, Porchet F, Kleinstück FS, Lattig F, Jeszenszky D, Bartanusz V, Dvorak J, Grob D (2009) The quality of spine surgery from the patient’s perspective: Part 2. Minimal clinically important difference for improvement and deterioration as measured with the Core Outcome Measures Index. Eur Spine J 18(Suppl 3):S374–S379CrossRefGoogle Scholar
- 42.Aghayev E, Sobottke R, Munting E, Pigott T, Perler G, Zweig T, Luca A, Mannion AF (2015) The international Spine Registry Spine Tango: annual report 2015. Eurospine. http://www.eurospine.org/cm_data/Spine_Tango_Report_International_2015_19_9_16.pdf Accessed 29 Oct 17
- 43.World Health Organization (2004) ICD-10: international statistical classification of diseases and related health problems. World Health Organization, GenevaGoogle Scholar
- 44.van Hooff ML, Mannion AF, Staub LP et al (2016) Determination of the Oswestry Disability Index score equivalent to a “satisfactory symptom state” in patients undergoing surgery for degenerative disorders of the lumbar spine—a Spine Tango registry-based study. Spine J 16(10):p1221–p1230CrossRefGoogle Scholar
- 45.Vogel S, Mars T, Keeping S, Barton T, Marlin N, Froud R, Eldridge S, Underwood M, Pincus T (2013) Clinical risk osteopathy and management scientific report: the CROaM study. http://www.osteopathy.org.uk/uploads/croam_full_report_0313.pdf. Accessed 03 Nov 2017