# The impact of elective spine surgery in Canada for degenerative conditions on patient reported health-related quality of life outcomes

## TL;DR

Spine surgery in Canada significantly improves patients' physical health-related quality of life, though not always to average population levels.

## Contribution

This study quantifies the impact of elective spine surgery on HRQoL outcomes across various degenerative spinal conditions in a large Canadian cohort.

## Key findings

- Patients showed significant improvement in physical component scores post-surgery compared to pre-surgery.
- Most patients achieved clinically meaningful improvements in physical health-related quality of life.
- Patients with cervical myelopathy had lower rates of achieving clinically meaningful improvements.

## Abstract

The impact of spine surgery on Health-Related Quality-of-Life (HRQoL) outcomes across common spinal degenerative diagnoses is not well characterised. A prospective observational study of patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) registry was performed. Baseline and 1-year post-operative Short Form-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were collated and compared to normative values from the Canadian General Population (CGP). The percentage of patients achieving the PCS Minimum Clinically Important Difference (MCID) was quantified. 5049 patients were included in the analysis. The mean pre-operative SF-12 PCS was 29.5 and MCS was 44.1. This improved to a mean PCS of 40.5 (p < 0.001) and MCS of 49.3 (p < 0.0001) at 1-year post-operatively. The mean pre-operative PCS was over 2 standard deviations (SD) lower than the normative mean of the CGP; this improved to being close to 1-SD from the normative CGP mean at 1-year post-operatively. Findings were similar across age- and sex-stratified subgroups. Across all conditions, 70–75% of patients achieved the PCS MCID. Fewer patients with cervical myelopathy achieved the PCS MCID (59%). In a surgical cohort, patients with degenerative spinal conditions demonstrate a profound reduction in PCS compared to their peers in the CGP. Spinal surgery was impactful in improving physical function HRQoL outcomes in the majority, but not typically to average population norms.

The online version contains supplementary material available at 10.1038/s41598-025-03613-4.