title: The incidence of spinal surgery in Canada.
abstract: OBJECTIVE
  To estimate the incidence of spinal surgery in 5 Canadian provinces over a 12-month period.
  
  
  METHODS
  Cumulative incidence study.
  
  
  METHODS
  Five provinces (63% of Canada's population).
  
  
  METHODS
  All patients who underwent spinal surgery between July 1, 1992, and June 30, 1993, in British Columbia, Alberta, Ontario, New Brunswick and Newfoundland.
  
  
  METHODS
  Overall spinal surgery rates per province and by age and sex.
  
  
  RESULTS
  In the 5 provinces over the allotted 12-month period, 12,329 spinal surgical procedures were performed. The overall rate of spinal surgery for the 5 provinces was 80 per 100,000 population. Ontario had the lowest rate of 61 per 100,000; British Columbia had the highest at 89 per 100,000. Men aged 40 to 49 years in Newfoundland had the highest overall rate at 210 per 100,000. Calculation of relative risks determined that Newfoundland's under-20 age groups for both sexes were almost 3 times as likely to undergo spinal surgery as the same age groups in Ontario (male relative risk = 2.73, female relative risk = 2.84). Males in British Columbia and Alberta had a statistically significant increased risk of surgery across all age groups except for those under 20 years old, and females in British Columbia showed a statistically significant increased risk of surgery across all age groups compared with those in Ontario. Males underwent 57.7% of all spine operations.
  
  
  CONCLUSIONS
  The incidence of spinal surgery is not uniform across Canada. Overall, the per capita rate is lower than in the United States. The explanation for this divergence remains unclear.
authors.affiliation: Research Department, Canadian Back Institute, Toronto, Ont. gmcintosh@cbi.ca
authors.forename: G
authors.initials: G
authors.lastname: McIntosh
authors.forename: H
authors.initials: H
authors.lastname: Hall
authors.forename: T
authors.initials: T
authors.lastname: Melles
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000706:statistics & numerical data*; D012307:Risk Factors; D013131:Spine / Q000601:surgery*