Healthy Spine Service
Emergency referrals
All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:
- RBWH (07) 3646 8111
- TPCH (07) 3139 4000
- Redcliffe (07) 3883 7777
- Caboolture (07) 5433 8888
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Risk irreversible deficit if not seen within 1-4 weeks
- Significant spinal nerve root compression or spinal cord compression with slower evolving neurological signs/symptoms
- Severe pain with significant functional impairment
- Suspected spinal tumours (benign or malignant)
- Moderate to severe sciatica with recent reflex and muscle power deficit eg. foot weakness
- Moderate to severe neck and arm pain with recent reflex and muscle power deficit
Category 2
Appointment within 90 days is desirable
- Less severe and more long-standing pain with significant functional impairment
- Acute cervical & lumbar disc prolapse with stable neurological signs/symptoms
- Severe degenerative spinal disorders with limitation of activity of daily living (ADL)
- Acute cervical or lumbar disc prolapse with mod-severe limb pain but minimal neurological deficit
- Documented severe lumbar canal stenosis with significant neurogenic claudication/limitation of walking distance
- Acute Pars defect in young adult
- Anterolisthesis/spondylolisthesis with lower limb neurology and/or instability on flex/ext x-rays
Category 3
Appointment within 365 days is desirable
- Mechanical lower back pain without lower limb pain
- Stable mild neurological symptoms/signs which is unlikely to progress if left untreated or in whom a good surgical outcome is uncertain
- Pain that is manageable or reasonably controlled with analgesia
- Chronic LBP/neck pain (without leg or arm pain)
- Most cases of chronic cervical and lumbar disc prolapse and degenerative spinal disorders with no to stable mild neurological deficit
- Long-standing spondylolisthesis with stable neurology
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
NB: Back pain with red flags – If clinical circumstances indicate the patient requires immediate treatment, refer to emergency.
Sheffield back pain Red Flags:
- age (at onset) < 16 or > 55
- motor deficit e.g. foot weakness
- recent significant trauma
- unexplained weight loss
- history of cancer
- history of IV drug use
- prolonged use of corticosteroids
- severe night pain
- infection/fever
Many Category 2 and 3 patients referred for a surgical opinion do not require surgery or a surgical opinion. Evidence demonstrates that non-surgical management is as effective for a number of spinal conditions.
Where services are available, category 2 and 3 patients will initially be assessed/reassessed and case managed by an expert musculoskeletal physiotherapist. Outcomes from this or subsequent review may include discharge, provision of appropriate non-surgical management plans, discussion or appointment with a spinal surgeon.
Management
- Analgesia/anti-inflammatories/NSAIDs as appropriate
- Physiotherapy/hydrotherapy/back education group (if available) – minimum 6 week program
- Strengthening exercises and aerobic fitness training
- Activity modification (remain comfortably active)
- Heat/gentle massage/acupuncture
- Monitor neurological function
- Complete ‘Keele STarT Back’ screening tool to identify risk of developing chronic spinal pain. Low to medium risk suggests ongoing management in primary care is appropriate.
Referral requirements
A referral may be rejected without the following information.
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways
Login to Brisbane North Health Pathways:
brisbanenorth.