Medical care
-
Lack of consensus about the treatment of low back pain is reflected by wide regional variations in lumbar spine surgery rates. Neck pain may be as common as low back pain, but there has been no similar evaluation of regional variation for the surgical treatment of neck pain. This report examines the geographic variation and temporal trends in the rate of cervical spine surgery in Washington state from 1986 through 1989. ⋯ Small area analysis demonstrated a sevenfold variation among counties in the rate of cervical spine surgery (P < 0.001), with variation of fourfold to 13-fold for specific surgical procedures. These data demonstrate that cervical spine surgery for neck pain is an increasingly common procedure with wide geographic variability. Rational treatment of neck pain requires further definition of indications for cervical spine surgery, preferably based on firm data concerning the outcomes of surgical and nonsurgical care.