STUDY DESIGN: Retrospective database analysis. OBJECTIVE: To examine the impact of training pathway, either neurosurgical or orthopedic, on complications, readmissions, and revisions in spine surgery. SUMMARY OF BACKGROUND DATA: Training pathway has been shown to have an impact on outcomes in various surgical subspecialties. Although training pathway has not been shown to have a significant impact on spine surgery outcomes in the perioperative period, long-term results are unknown. MATERIALS AND METHODS: A retrospective analysis of 197,682 patients receiving 1 of 3 common spine surgeries [lumbar laminectomy, lumbar fusion, and anterior cervical discectomy and fusion (ACDF)] between 2006 and 2010 was conducted. Patient data were obtained from a large claims database. Postoperative adverse effects, all-cause readmission, revision surgery rates, and intermediary payments in these cohorts of patients were compared between spine surgeons with either neurosurgical or orthopedic backgrounds. RESULTS: Patient demographics, hospital-stay characteristics, and medical comorbidities were similar between neurosurgeons and orthopedic surgeons. The risks of surgical complications, all-cause readmission, and revision surgery were also similar between neurosurgeons and orthopedic surgeons across all procedure types assessed, with several minor exceptions: neurosurgeons had marginally higher odds of any complication for lumbar fusions [odds ratio (OR) 1.14; 95% confidence interval (CI), 1.09-1.20] and ACDFs (OR, 1.09; 95% CI, 1.04-1.15). Neurosurgeons also had slightly higher rates of revision surgery for concurrent lumbar laminectomy with fusion (OR, 1.14; 95% CI, 1.08-1.22), and ACDFs (OR, 1.20; 95% CI, 1.14-1.28). No associations between surgeon type and any particular complication were consistently observed for all procedure groups. There were also no associations between surgeon type and 30-day all-cause readmission. Median total intermediary payments were somewhat higher for neurosurgery patients for all procedure groups assessed. CONCLUSIONS: Few significant associations between surgeon type and patient outcomes exist in the context of spine surgery. Those which do are small and unlikely to be clinically meaningful. LEVEL OF EVIDENCE: Level 3.
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: To examine the impact of training pathway, either neurosurgical or orthopedic, on complications, readmissions, and revisions in spine surgery. SUMMARY OF BACKGROUND DATA: Training pathway has been shown to have an impact on outcomes in various surgical subspecialties. Although training pathway has not been shown to have a significant impact on spine surgery outcomes in the perioperative period, long-term results are unknown. MATERIALS AND METHODS: A retrospective analysis of 197,682 patients receiving 1 of 3 common spine surgeries [lumbar laminectomy, lumbar fusion, and anterior cervical discectomy and fusion (ACDF)] between 2006 and 2010 was conducted. Patient data were obtained from a large claims database. Postoperative adverse effects, all-cause readmission, revision surgery rates, and intermediary payments in these cohorts of patients were compared between spine surgeons with either neurosurgical or orthopedic backgrounds. RESULTS:Patient demographics, hospital-stay characteristics, and medical comorbidities were similar between neurosurgeons and orthopedic surgeons. The risks of surgical complications, all-cause readmission, and revision surgery were also similar between neurosurgeons and orthopedic surgeons across all procedure types assessed, with several minor exceptions: neurosurgeons had marginally higher odds of any complication for lumbar fusions [odds ratio (OR) 1.14; 95% confidence interval (CI), 1.09-1.20] and ACDFs (OR, 1.09; 95% CI, 1.04-1.15). Neurosurgeons also had slightly higher rates of revision surgery for concurrent lumbar laminectomy with fusion (OR, 1.14; 95% CI, 1.08-1.22), and ACDFs (OR, 1.20; 95% CI, 1.14-1.28). No associations between surgeon type and any particular complication were consistently observed for all procedure groups. There were also no associations between surgeon type and 30-day all-cause readmission. Median total intermediary payments were somewhat higher for neurosurgery patients for all procedure groups assessed. CONCLUSIONS: Few significant associations between surgeon type and patient outcomes exist in the context of spine surgery. Those which do are small and unlikely to be clinically meaningful. LEVEL OF EVIDENCE: Level 3.
Authors: Safwan Alomari; Daniel Lubelski; Sheng-Fu L Lo; Nicholas Theodore; Timothy Witham; Daniel Sciubba; Ali Bydon Journal: Eur Spine J Date: 2022-05-21 Impact factor: 2.721
Authors: Jong-Myung Jung; Si Un Lee; Seung-Jae Hyun; Ki-Jeong Kim; Tae-Ahn Jahng; Chang Wan Oh; Hyun-Jib Kim Journal: J Korean Neurosurg Soc Date: 2019-08-14
Authors: Franz H Vergara; Jean E Davis; Chakra Budhathoki; Nancy J Sullivan; Daniel J Sheridan Journal: Popul Health Manag Date: 2019-08-08 Impact factor: 2.459
Authors: Ruggero Belluomo; Inazio Arriola-Alvarez; Nathan W Kucko; William R Walsh; Joost D de Bruijn; Rema A Oliver; Dan Wills; James Crowley; Tian Wang; Florence Barrère-de Groot Journal: Materials (Basel) Date: 2022-02-11 Impact factor: 3.623
Authors: Lukas A van Dijk; Florence Barrère-de Groot; Antoine J W P Rosenberg; Matthew Pelletier; Chris Christou; Joost D de Bruijn; William R Walsh Journal: Clin Spine Surg Date: 2020-07 Impact factor: 1.723