MONDAY, March 28 (HealthDay News) -- "Surgeon enthusiasm" is a major reason why surgeons in some areas are more likely to recommend surgery for low back problems, according to a new study.

Researchers analyzed data on more than 50,000 low back surgeries performed in the province of Ontario, Canada, between 2002 and 2006. As in the United States, Ontario has some significant area variations in spinal surgery rates.

The study found that surgeons in counties with higher rates of spinal surgery were more likely to recommend surgery for back problems, meaning they had more enthusiasm. Spinal surgery rates were 20 percent higher in counties ranked in the top quarter of surgeon enthusiasm, compared with counties in the bottom quarter of surgeon enthusiasm.

Patient or family-doctor enthusiasm for back surgery had no effect on spinal surgery rates, nor did local differences in rates of degenerative spinal disease.

"Surgeon enthusiasm was found to be the dominant potentially modifiable factor influencing surgical rates," wrote Dr. S. Samuel Bederman, of the University of California, Irvine, and colleagues.

Other factors include the availability of MRI and patient age, sex and income.

The study was published in the March 15 issue of the journal Spine.

"Strategies targeting surgeon practices may reduce regional variation in care and improve access disparities," the researchers wrote in a journal news release.

More information

The American Academy of Orthopaedic Surgeons has more about low back surgery.