Specific versus non-specific hospital-based spine diagnoses in children and adolescents: a nationwide register-based cohort study

Abstract Background Paediatric spine pain is common, yet little is known about the influence of patient characteristics on diagnostic classification in hospital settings. Objective Describe diagnostic code variation by age, sex, parental spine diagnoses, and child comorbidity burden. Methods Nationwide historical (2007–2022) register-based cohort study including Danish 0-17-year-olds with a hospital-based spine-related diagnosis. Diagnoses were classified as specific or non-specific by ICD-10 codes. Patient characteristics were examined descriptively and with logistic regression. Results Of 49,596 children, 63% received a non-specific diagnosis. Non-specific diagnoses were more common among older children (OR ~ 0.22–0.27), children with parental spine-related diagnoses (OR = 0.77), male children (OR = 1.07), or children with lower comorbidity burden (OR ~ 1.09–1.13). Conclusions Diagnostic classification of paediatric spinal pain varies systematically by patient characteristics. Most children receive non-specific diagnoses, underscoring the need for the development of appropriate care pathways including greater use of primary care for non-specific spinal pain.