Spine Assessment Clinic improving access to care for Nova Scotians with neck and back pain

Nova Scotians living with neck and back pain now have improved access to the right care in the right place, by the right providers thanks to Nova Scotia Health’s Spine Assessment Clinic (SAC).

In the past, these patients would often face long waits to see a spine surgeon, only to learn surgery was not needed. In fact, less than 10 per cent of patients referred to surgeons ultimately went on to require surgery.

Since the fall of 2023, the SAC has been providing patients with more timely initial assessments and connecting them to the care pathway that best supports their needs, whether that’s physiotherapy, home or community-based supports, or surgical consultation. This new approach helps reduce unnecessary wait times for surgery and MRI imaging, while easing the demand on primary care and emergency departments.

“Historically, many patients would wait months or even years to see a surgeon, only to find out they didn’t need surgery,” said Dr. Sean Christie, head of the Division of Neurosurgery at Nova Scotia Health and Dalhousie University. “The SAC allows us to see patients much earlier, direct them to the most appropriate care and help improve their outcomes, faster.”

Patients across Nova Scotia living with ongoing neck and back pain can now be referred to the Spine Assessment Clinic. These referrals are co-ordinated through the surgical Central Intake team to enhance communication with patients and providers and support more timely access to care.

Over 5,000 patients have already been assessed. Most of these patients will benefit from non-surgical care such as physiotherapy, education about long term management of spinal pain and connecting patients to community supports, like exercise groups and nutrition support.

“The biggest impact is on wait times,” said Christie. “Our team has worked hard to validate referrals to the clinic, ensuring only those who most likely require surgery see the surgeon, while providing direction and education to the others. This has allowed patients to be seen sooner, supporting them in managing their condition more effectively and reserve surgical resources for those who may truly benefit from them.”

In the past, many patients referred to spine surgeons also had imaging such as an MRI completed before seeing the surgeon. Research has shown almost 40 per cent of MRIs ordered were not warranted. To avoid unnecessary delays or imaging, the clinic now asks that patients be referred without first getting imaging. The clinic will determine if imaging is necessary.

Located at different sites across the Halifax Regional Municipality (Dartmouth General Hospital, Halifax Infirmary Veterans Memorial Building and Cobequid Community Health Centre), the SAC is staffed by a multidisciplinary team of physiotherapists, a nurse, a nurse practitioner and surgeons. Patients referred to the clinic are also supported by Nova Scotia’s electronic referral system (Ocean eReferrals), which streamlines communication between primary care providers, specialists and patients.

Spine Assessment Clinic funding was provided to support ongoing efforts to reduce wait times and improve access to surgical care across the province.

With back and neck pain the most common cause of disability worldwide and an aging population driving increased demand, the SAC is already proving to be a vital piece of the healthcare puzzle. By ensuring patients receive earlier, appropriate care, the clinic is improving quality of life for Nova Scotians while also reducing demand for surgical resources.

Learn more about how we are transforming surgical and endoscopy access and care.

Photo of (L-R) Jason Freeman, Physiotherapist; Michelle Rowicki, Registered Nurse; Justina Gillis, Nurse Practitioner; Julie Gates, Program Coordinator – Spine Assessment Clinic; Leslie Hardy, Booking and Registration Clerk. Missing from photo: Karen Jones, Physiotherapist; Tanya Nichol, Physiotherapist; Samantha Withrow, Booking and Registration Clerk; Alissa Decker, Director; Christina MacDonald, Program Manager, Bone and Joint-Rehabilitation Support Care Services; Dr. Sean Christie, Division Head- Neurosurgery; and Dr Bill Oxner, Division Head- Orthopedics.