EPIDEMIOLOGICAL PROFILE OF SPINE SURGERY AND OUTPATIENT CARE IN THE BRAZILIAN UNIFIED HEALTH SYSTEM (SUS)

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Abstract
Objective: To create and implement a structured database for patients treated by the spine surgery team at Santa Casa de Misericórdia de São Paulo, analyzing the epidemiological profile, therapeutic strategies, and clinical outcomes. Methods: Retrospective observational study including 5,085 patients treated between 2016 and 2024, comprising 4,192 outpatient consultations and 893 surgical procedures. Data were prospectively collected and recorded on the REDCap platform, including demographic information, diagnoses, treatments, clinical evolution, and standardized questionnaires. Statistical analyses were performed using R software. Results: The mean age was 46.2 ± 20.6 years, with a male predominance in outpatient care (57.8%). Low back pain and degenerative diseases were the most frequent diagnoses (26.2%), followed by lumbar disc herniation (7.6%) and thoracolumbar fractures (7.3%). In the surgical group, metastases (12.3%) and fractures (10.6%) stood out. Conservative treatment was recommended in 71.4% of outpatient cases. Among surgical patients, 47.6% underwent instrumentation, mostly via posterior approach (84.9%). The mean Oswestry Disability Index (ODI) was 31.0. Women reported higher pain intensity but showed better neurological outcomes. The surgical complication rate was 9.2%, with satisfactory evolution in 90.8% of operated cases. Conclusion: This study highlights the predominance of degenerative diseases and low back pain in outpatient settings and underscores the essential role of surgery in complex cases. The implementation of the REDCap database proved effective for clinical monitoring, contributing to the improvement of therapeutic practices and future research in spine surgery. Level of Evidence IV; Retrospective observational study.

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