CERTAIN is helping improve the quality of spine care by conducting research into what treatments work for which types of patients.
Low back pain is common and expensive, with estimated annual associated costs for patients, employers, and insurers exceeding $25 billion each year in the United States. Treatments for chronic low back pain have varying degrees of invasiveness, from physical therapy to steroid injections to surgeries. Surgical and other interventional procedures are being increasingly used, but many questions need to be addressed to make sure that the greatest number of people with chronic pain get the right treatments at the right time.
Surgery is an increasingly common treatment for chronic low back pain (1,2) but evidence is mixed about whether surgery results in superior clinical and patient-reported outcomes, such as improvements in pain intensity, functional disability, and quality of life when compared to patients who did not have surgery (3,4,5). There have been several randomized controlled trials of treatments for chronic low back pain, but these are often limited in their application to the real world with diverse patients, providers, and care settings.
Real world research is needed to truly understand the most appropriate treatments for chronic low back pain. These types of assessments designed to determine the effects of an intervention under “usual,” or real world conditions, are called comparative effectiveness research (CER).
CERTAIN is working to fill gaps in knowledge about for whom, how, and when treatments for the spine work best by developing comparative effectiveness research that offers real-world comparative assessments of treatments for spine conditions. CERTAIN brings together leaders in surgical and non-surgical fields to help extend our knowledge of what works by comparing important outcomes of more and less invasive treatments. We engage the perspectives of all stakeholders—physicians, patients, payers, and policymakers—in the development of quality improvement and research activities to improve clinical care.
Current Research in Spine Care
Understanding Non-Response in Spine Fusion Surgery
Helping determine which patients will respond to spine fusion surgery and which will not benefit.
Topical Antibiotic Treatment for Spine Surgical Site Infections
Understanding surgeon practices and beliefs around in-wound antibiotics.