Spinal surgery in Canada
========================

* Ken Yong-Hing

McIntosh and his colleagues (“The incidence of spinal surgery in Canada” [*Can J Surg* 1998; 41(1):59–66]) have taken on the gargantuan task of measuring the incidence of spinal surgery in 5 provinces in Canada. As their laudable aim, implied in the introduction of their paper, is to explain the soaring costs of treating back pain, their results must be interpreted in the correct context.

The rate of spinal surgery that they have reported (80 per 100 000 population) includes surgery for categories of disease other than back and neck pain caused by degenerative diseases (e.g., disc disease, spinal stenosis, spondylolisthesis) such as deformities, tumours, fractures, infections, congenital and developmental conditions of the spine. It is possible that the prevalences of one or more of these conditions are different in the 5 provinces.