4.1 Lumbar spinal fusion, 18 years and over

Lumbar spinal fusion is a type of surgery that is sometimes used to treat chronic low back pain and other symptoms of degenerative spinal disorders. Find out about variation in lumbar spinal fusion rates in the Fourth Australian Atlas of Healthcare Variation 2021.

At a glance

  • Degenerative spinal disorders are a diverse group of conditions that can cause chronic low back pain, leg pain and disability
  • Lumbar spinal fusion surgery has a role in treating a small number of people who have degenerative spinal disorders with nerve-related problems. The role of spinal fusion in people without these problems is limited and controversial
  • Spinal surgery for treating infection, tumours or injury, was excluded from examination in the Atlas
  • After standardising to remove age and sex differences between populations, the rate of hospitalisation for lumbar spinal fusion in 2015–2018 was more than 12 times as high in the area with the highest rate compared with the area with the lowest rate. The rate had declined since 2012–2015
  • To address variation, it is important to improve access to multidisciplinary review and non-surgical treatments for chronic low back pain, and to develop the Australian Spine Registry to collect data on patient outcomes and support audit and peer review.

Interactive maps, graphs and data

Data show variation in rates by geographic location of patient residence. To use the interactive maps and graphs:

  • Hover or click on maps and graphs for details of data points
  • Use the dropdown boxes at the bottom of graphs to select states and territories, SA3s or PHNs

Learn more about using the interactive Atlas or how to interpret the data.

Map of rates across Australia

Rates by local area

//viz.aihw.gov.au/t/Public/views/Histogram_LS_fusion/Histogram?%3Aiid=1&%3Aembed=y#1

Rates by state and territory

//viz.aihw.gov.au/t/Public/views/SOP_LS_fusion/Stateandterritory?%3Aiid=1&%3Aembed=y#1

Rates by remoteness and SES

//viz.aihw.gov.au/t/Public/views/SOP_LS_fusion/RemotenessandSES?:iid=1&:embed=y#1

About the data

About the data  - Lumbar spinal fusion, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for  lumbar spinal fusion (with or without decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data   collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

Principal diagnoses included and the percentage of hospitalisations for lumbar spinal fusion with or without decompression for 2015–2018 are:

  • Spinal stenosis (lumbar and lumbosacral), 36%
  • Lumbar and other intervertebral disc disorders with radiculopathy, 21%
  • Spondylolisthesis (lumbar and lumbosacral), 25%
  • Radiculopathy (lumbar and lumbosacral), 5%
  • Low back pain, 5%
  • Other specified intervertebral disc displacement, 5%
  • Lumbago with sciatica, 1%
  • Lumbar and other intervertebral disc disorders with myelopathy, 1%
  • Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

2021
Publication, report or update

Map of rates across Australia

Rates by local area

//viz.aihw.gov.au/t/Public/views/Histogram_LS_fusion/Histogram?%3Aiid=1&%3Aembed=y#1

Rates by state and territory

//viz.aihw.gov.au/t/Public/views/SOP_LS_fusion/Stateandterritory?%3Aiid=1&%3Aembed=y#1

Rates by remoteness and SES

//viz.aihw.gov.au/t/Public/views/SOP_LS_fusion/RemotenessandSES?:iid=1&:embed=y#1

About the data

About the data  - Lumbar spinal fusion, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for  lumbar spinal fusion (with or without decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data   collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

Principal diagnoses included and the percentage of hospitalisations for lumbar spinal fusion with or without decompression for 2015–2018 are:

  • Spinal stenosis (lumbar and lumbosacral), 36%
  • Lumbar and other intervertebral disc disorders with radiculopathy, 21%
  • Spondylolisthesis (lumbar and lumbosacral), 25%
  • Radiculopathy (lumbar and lumbosacral), 5%
  • Low back pain, 5%
  • Other specified intervertebral disc displacement, 5%
  • Lumbago with sciatica, 1%
  • Lumbar and other intervertebral disc disorders with myelopathy, 1%
  • Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

2021
Publication, report or update

Rates by patient funding status

Rates for Aboriginal and Torres Strait Islander people

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionwithorwithoutdecompression/RatesbyAboriginalandTorresStraitIslanderstatus?%3Aiid=2&%3Aembed=y#1

Rates by age group

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionwithorwithoutdecompression/Ratesbyagegroup?%3Aiid=2&%3Aembed=y#1

About the data

About the data  - Lumbar spinal fusion, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for  lumbar spinal fusion (with or without decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data   collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

Principal diagnoses included and the percentage of hospitalisations for lumbar spinal fusion with or without decompression for 2015–2018 are:

  • Spinal stenosis (lumbar and lumbosacral), 36%
  • Lumbar and other intervertebral disc disorders with radiculopathy, 21%
  • Spondylolisthesis (lumbar and lumbosacral), 25%
  • Radiculopathy (lumbar and lumbosacral), 5%
  • Low back pain, 5%
  • Other specified intervertebral disc displacement, 5%
  • Lumbago with sciatica, 1%
  • Lumbar and other intervertebral disc disorders with myelopathy, 1%
  • Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

2021
Publication, report or update

Rates by patient funding status

Rates for Aboriginal and Torres Strait Islander people

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionwithorwithoutdecompression/RatesbyAboriginalandTorresStraitIslanderstatus?%3Aiid=2&%3Aembed=y#1

Rates by age group

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionwithorwithoutdecompression/Ratesbyagegroup?%3Aiid=2&%3Aembed=y#1

About the data

About the data  - Lumbar spinal fusion, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for  lumbar spinal fusion (with or without decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data   collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

Principal diagnoses included and the percentage of hospitalisations for lumbar spinal fusion with or without decompression for 2015–2018 are:

  • Spinal stenosis (lumbar and lumbosacral), 36%
  • Lumbar and other intervertebral disc disorders with radiculopathy, 21%
  • Spondylolisthesis (lumbar and lumbosacral), 25%
  • Radiculopathy (lumbar and lumbosacral), 5%
  • Low back pain, 5%
  • Other specified intervertebral disc displacement, 5%
  • Lumbago with sciatica, 1%
  • Lumbar and other intervertebral disc disorders with myelopathy, 1%
  • Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

2021
Publication, report or update

National overview

Rates by state and territory across years

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionwithorwithoutdecompression/Stateandterritoryratesacrossyears?%3Aiid=2&%3Aembed=y#2

About the data

About the data  - Lumbar spinal fusion, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for  lumbar spinal fusion (with or without decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data   collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

Principal diagnoses included and the percentage of hospitalisations for lumbar spinal fusion with or without decompression for 2015–2018 are:

  • Spinal stenosis (lumbar and lumbosacral), 36%
  • Lumbar and other intervertebral disc disorders with radiculopathy, 21%
  • Spondylolisthesis (lumbar and lumbosacral), 25%
  • Radiculopathy (lumbar and lumbosacral), 5%
  • Low back pain, 5%
  • Other specified intervertebral disc displacement, 5%
  • Lumbago with sciatica, 1%
  • Lumbar and other intervertebral disc disorders with myelopathy, 1%
  • Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

National overview

Rates by state and territory across years

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionwithorwithoutdecompression/Stateandterritoryratesacrossyears?%3Aiid=2&%3Aembed=y#2

About the data

About the data  - Lumbar spinal fusion, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for  lumbar spinal fusion (with or without decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data   collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

Principal diagnoses included and the percentage of hospitalisations for lumbar spinal fusion with or without decompression for 2015–2018 are:

  • Spinal stenosis (lumbar and lumbosacral), 36%
  • Lumbar and other intervertebral disc disorders with radiculopathy, 21%
  • Spondylolisthesis (lumbar and lumbosacral), 25%
  • Radiculopathy (lumbar and lumbosacral), 5%
  • Low back pain, 5%
  • Other specified intervertebral disc displacement, 5%
  • Lumbago with sciatica, 1%
  • Lumbar and other intervertebral disc disorders with myelopathy, 1%
  • Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

Lumbar fusion excluding decompression

Rates by state and territory

Rates by patient funding status

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionexcludingdecompression/Ratesbypatientfundingstatus?%3Aiid=1&%3Aembed=y#1

Rates by state and territory across years

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionexcludingdecompression/Stateandterritoryratesacrossyears?:iid=1&:embed=y#1

Rates by age group

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionexcludingdecompression/Ratesbyagegroup?%3Aiid=1&%3Aembed=y#3

About the data

About the data - Lumbar spinal fusion excluding decompression, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for lumbar spinal fusion (excluding decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

Rates by state and territory

Rates by patient funding status

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionexcludingdecompression/Ratesbypatientfundingstatus?%3Aiid=1&%3Aembed=y#1

Rates by state and territory across years

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionexcludingdecompression/Stateandterritoryratesacrossyears?:iid=1&:embed=y#1

Rates by age group

//viz.aihw.gov.au/t/Public/views/Additional_Lumbarspinalfusionexcludingdecompression/Ratesbyagegroup?%3Aiid=1&%3Aembed=y#3

About the data

About the data - Lumbar spinal fusion excluding decompression, 18 years and over

Data are sourced from the National Hospital Morbidity Database, and include admitted patients in both public and private hospitals.

Rates are based on the number of hospitalisations for lumbar spinal fusion (excluding decompression) per 100,000 people aged 18 years and over in 2012–13 to 2014–15 and 2015–16 to 2017–18. Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis.

Because a record is included for each hospitalisation for the procedure, rather than for each patient, patients hospitalised for the procedure more than once in the financial year will be counted more than once.

It is not possible to estimate rates of staged surgery across separate hospitalisations from these data. Hospitalisations for the same patient have not been linked. Therefore, a patient who was hospitalised for spinal fusion without decompression may have had a hospitalisation for decompression in the same data collection period.

The analysis and maps are based on the usual residential address of the patient and not the location of the hospital.

Rates are age and sex standardised to allow comparisons between populations with different age and sex structures. Data quality issues – for example, the extent of identification of Aboriginal and Torres Strait Islander status in datasets – could influence the variation seen.

It is not possible to examine variation in fusion for chronic axial back pain at a small area level because of confidentiality reasons.

 

About the Atlas and how to interpret the data visualisations

This document outlines how to interpret the data correctly and explains the limitations of the data prior to using the Atlas:

Technical Supplement

Download the Technical Supplement: 

2021
Publication, report or update

Technical Supplement

Download the Technical Supplement: 

2021
Publication, report or update