Spine Centers in Northeastern United States: Assessing Similarities and Disparities to Build more Homogeneity Across...

Spine centers are common, but no standardized regulations govern their designation. Existing certifications are issued by multiple independent organizations and are not necessarily equivalent, while many centers remain non-accredited. Consequently, centers may vary in qualifications, quality of care, and services. This study examined and compared the defining characteristics of spine centers in Northeast America.

A total of 194 spine centers were identified and compared based on accreditation, services, provider numbers, and proximity to metropolitan areas. Accreditation requirements from The Joint Commission (TJC), Det Norske Veritas (DNV), Aetna, and Blue Cross Blue Shield (BCBS) were analyzed. While substantial overlap existed, Aetna and BCBS largely built upon TJC standards, whereas DNV requirements differed, and exact criteria varied across organizations. Overall, 56% of centers were accredited. Compared with non-accredited centers, accredited centers more frequently employed neurosurgeons, offered multidisciplinary care, and were affiliated with academic medical centers. Logistic regression demonstrated that employment of neurosurgeons and academic affiliation independently predicted accreditation. Accredited centers also tended to be closer to metropolitan areas and employed more providers. However, rates of non-surgical treatment, minimally invasive surgery, and physical therapy services were similar regardless of accreditation status. Although accredited centers reported certain characteristics at higher rates, the variability between accreditation requirements and similarity between accredited and non-accredited centers could confuse prospective patients. While this study provides a preliminary profile of Northeast spine centers, our findings reinforce the need for standardized guidelines for spine center status.