What measurement means for lumbar fusion surgery

Lumbar fusion surgery is an option to treat low back pain caused by motion. Lumbar fusion surgery joins, or fuses, painful vertebrae in the lower spine so they heal into a single bone. The goal of lumbar fusion surgery is to improve pain, function and mobility so you can continue with daily activities such as sitting, standing and walking.

The Lumbar Fusion Surgery: Pain, Function and Mobility measure reports the amount of change in pain, function and mobility after lumbar fusion surgery based on feedback from patients one year after surgery. This is called a Patient-Reported Outcome (PRO) measure because it uses the patient's own rating of their pain, function and mobility as a way to measure the quality of care.

Patient outcomes are measured on a 100-point scale.

The statewide average change in score for patients who had lumbar fusion surgery among all reporting medical groups is 20.1 points. This means that on a scale of 0 to 100 points, the average change in function after surgery was 20.1 points. 

Reportable medical groups ranged between an average change of 14.5 and 25.7 points. A higher change in score is a sign of greater improvements in a patient’s pain, function and mobility after lumbar fusion surgery.

It’s important to know that small differences in scores don’t necessarily reflect the quality of care you’ll receive with a specific medical group. It is more important to note large differences between providers, and speak with your doctor if you have questions or concerns.

Don’t see your medical group listed? While some of the medical groups in Minnesota that provided data for this measure didn’t have enough patients to have valid, reportable results, other medical groups chose not to submit data at all. For consumers, this means that some important information is missing that would help you have a better understanding of the outcomes from this surgery.

How we calculate the measure

We measure how patients feel based on their responses to a tool called the Oswestry Disability Index (ODI) that asks 10 questions about back pain, function and mobility. Lumbar fusion surgery patients are asked to complete the tool before surgery and one year after surgery. Based on the answers, the tool calculates a simple score that shows how severe a patient’s lower back problems are. By comparing the score before surgery and after surgery, we are able to report the amount of change experienced by patients.

This report is based on surgeries performed between January 1 and December 31, 2016. This information is collected under the measure name Spine Surgery - Lumbar Spinal Fusion.

Risk-adjusted measures

The information reported about this measure on MNHealthScores is risk-adjusted.

Risk adjustment is a way to make it easier to compare clinics or medical groups by accounting for the differences of specific patient groups. The process should separate the clinic/medical group’s true impact on patients’ health and allow them to be compared more easily.

MN Community Measurement uses an actual-to-expected process, which is also known as a methodology. This process does not change a clinic/medical group’s result; the actual rate remains the same. Instead, each clinic/medical group’s actual rate is compared to the rate that we expected to see, based on the different types of patient characteristics seen at that clinic/medical group.

More details about our risk adjustment methodology and the variables used for the measures reported on MNHealthScores.org can be found in the most current Health Care Quality Report.