Clinics (Sao Paulo). 2017 August; 72(8): 485-490.

Copyright © 2017 CLINICS

Community Care Administration of Spinal Deformities in the Brazilian Public Health System

Mario Bressan-Neto I * , Carlos Fernando Pereira da Silva Herrero I , Lilian Maria Pacola I , Altacílio Aparecido Nunes II , Helton Luiz Aparecido Defino I

Departamento de Biomecanica, Medicina e Reabilitacao do Aparelho Locomotor, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, SP, BR

Departamento de Medicina Social, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, SP, BR

*Corresponding author. E-mail:

received December 30, 2016; revised March 16, 2017; accepted May 16, 2017.



Underfunding of the surgical treatment of complex spinal deformities has been an important reason for the steadily growing waiting lists in publicly funded healthcare systems. The aim of this study is to characterize the management of the treatment of spinal deformities in the public healthcare system.


A cross-sectional study of 60 patients with complex pediatric spinal deformities waiting for treatment in December 2013 was performed. The evaluated parameters were place of origin, waiting time until first assessment at a specialized spine care center, waiting time for the surgical treatment, and need for implants not reimbursed by the healthcare system.


Ninety-one percent of the patients lived in São Paulo State (33% from Ribeirão Preto - DRS XIII). Patients waited for 0.5 to 48.0 months for referral, and the waiting times for surgery ranged from 2 to 117 months. Forty-five percent of the patients required implants for the surgical procedure that were not available.


The current management of patients with spinal deformities in the public healthcare system does not provide adequate treatment for these patients in our region. They experience long waiting periods for referral and prolonged waiting times to receive surgical treatment; additionally, many of the necessary procedures are not reimbursed by the public healthcare system.

Keywords: Spine, Waiting Lists, Scoliosis, Spinal Curvatures, Healthcare Financing

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