Oral Presentation Sydney Spinal Symposium 2022

A content analysis of online information about the benefits and harms of spine surgery (#14)

Giovanni Ferreira 1 , Joshua Zadro 1 , Mary O'Keeffe 1 , Meilin Chen 2 , Yiyi Gao 2 , Ziqi Hu 2 , Ziyun Zhang 2 , Ian Harris 3 , Christopher Maher 1
  1. Institute for Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney Local Health District & The University of Sydney, Sydney, NSW, Australia
  2. The University of Sydney, Camperdown, NSW, Australia
  3. Ingham Institute of Applied Medical Research, Southwestern Sydney Local Health District and University of New South Wales, Sydney, NSW, Australia

Aims: To describe the proportion of consumer webpages containing information about surgery for spinal pain that accurately described the evidence on the benefits of surgery, described harms and provided quantitative estimates of these harms.

Methods: We performed a content analysis. Webpages containing information for consumers about two common types of spine surgeries – decompression and fusion. We identified webpages through Google using search terms synonymous with ‘spine fusion’ and ‘spine decompression surgery’. Two independent reviewers identified webpages and extracted the data. Outcomes were the proportion of webpages that had an accurate description of evidence on the benefits, described harms, and provided quantitative estimates of these harms.

Results: A total of 117 webpages were included. Only 29 (25%) had an accurate description of evidence on the benefits of spine surgery. A greater proportion of webpages on decompression had an accurate description of evidence on the benefits compared to webpages on fusion (31% vs 15%, difference in proportions 16%, 95% CI 2% to 31%; p = 0.02). Harms of surgery were described in most webpages (n = 76, 65%), but only a much smaller proportion of webpages (n = 18, 15%) provided a quantitative estimate for the mentioned harms, with no difference between webpages on decompression and fusion.

Conclusion: Most webpages failed accurately describe the evidence on the benefits of decompression and fusion for spinal pain. Harms were described in two thirds of pages, but only a very small proportion provided a quantitative estimate of harms. Unbiased consumer resources and educating the public on how to critically evaluate health claims are important steps to improve knowledge on the benefits and harms of spine surgery.