Variations in surgical approach to lumbar degenerative diseases may depend on a patient's clinical condition. This study found strong agreement in the approach to lytic spondylolisthesis but significant variation for other degenerative conditions of the lumbar spine. In addition, recommendation for fusion and instrumentation varied with surgeon age and training background. Previously documented geographic variations may result in part from a lack of consensus on appropriate treatment techniques for specific lumbar degenerative conditions, as well as surgeon-specific factors.

Variations in surgical procedures for cervical degenerative disease may depend on the clinical condition. Although this study found strong agreement in treatment approach to single-level disc herniation, significant variation was seen for the other degenerative conditions of the cervical spine. While differences in recommendation for fusion were not clearly associated with surgeon age, there was a trend toward the higher use of instrumentation by younger surgeons. Previously documented geographic variation may result in part from a lack of consensus regarding appropriate treatment techniques for certain degenerative conditions of the cervical spine, as well as surgeon-specific factors.

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