Jefferson R Wilson1, Kris Radcliff2, Gregory Schroeder2, Madison Booth3, Christopher Lucasti4, Michael Fehlings5, Nassr Ahmad6, Alexander Vaccaro2, Paul Arnold7, Daniel Sciubba8, Alex Ching9, Justin Smith10, Christopher Shaffrey10, Kern Singh11, Bruce Darden12, Scott Daffner13, Ivan Cheng14, Zoher Ghogawala15, Steven Ludwig16, Jacob Buchowski17, Darrel Brodke18, Jeffrey Wang19, Ronald A Lehman20, Alan Hilibrand2, Tim Yoon21, Jonathan Grauer22, Andrew Dailey23, Michael Steinmetz24, James S Harrop4. 1. Department of Neurosurgery, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada. 2. Rothman Institute, Thomas Jefferson University, Philadelphia, PA. 3. St. Michael's Hospital, Toronto, ON, Canada. 4. Division of Neurosurgery, Thomas Jefferson University, Philadelphia PA. 5. Division of Neurosurgery, Toronto Western Hospital, Toronto, ON, Canada. 6. Department of Orthopoaedic Surgery, Mayo Clinic, Rochester, MA. 7. Department of Neurosurgery, University of Kansas, Kansas City, KS. 8. Department of Neurosurgery, Johns Hopkins University, Baltimore, MD. 9. Department of Orthopaedic Surgery, Oregon Spine Care, Tualatin, OR. 10. Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA. 11. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL. 12. Deperatment of Orthopaedics, Carolina Spine Center, Charlotte, NC. 13. Department of Orthopaedics, West Virginia University, Morgantown, WV. 14. Department of Orthopaedic Surgery, Stanford University Medical Center, Portola Valley, CA. 15. Department of Neurosurgery, Lahey Hospital and Medical Center, Burlington, MA. 16. Department of Orthopaedics, University of Maryland Medical System, Baltimore, MD. 17. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO. 18. Department of Orthopaedics, University of Utah Orthopaedic Center, Salt Lake City, UT. 19. Orthopaedic Spine Service, USC Spine Center, Los Angeles, CA. 20. Department of Orthopaedics, Columbia University Medical Center, New York, NY. 21. Department of Orthopedics, Emory University, Atlanta, GA. 22. Department of Orthopaedics, Yale University School of Medicine, New Haven, CT. 23. Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT. 24. Department of Neurosurgery, Cleveland Clinic, Cleveland, OH.
Abstract
PURPOSE: Anterior cervical discectomy and fusion has a low but well-established profile of adverse events. The goal of this study was to gauge surgeon opinion regarding the frequency and acceptability of these events. METHODS: A 2-page survey was distributed to attendees at the 2015 Cervical Spine Research Society (CSRS) meeting. Respondents were asked to categorize 18 anterior cervical discectomy and fusion-related adverse events as either: "common and acceptable," "uncommon and acceptable," "uncommon and sometimes acceptable," or "uncommon and unacceptable." Results were compiled to generate the relative frequency of these responses for each complication. Responses for each complication event were also compared between respondents based on practice location (US vs. non-US), primary specialty (orthopedics vs. neurosurgery) and years in practice. RESULTS: Of 150 surveys distributed, 115 responses were received (76.7% response rate), with the majority of respondents found to be US-based (71.3%) orthopedic surgeons (82.6%). Wrong level surgery, esophageal injury, retained drain, and spinal cord injury were considered by most to be unacceptable and uncommon complications. Dysphagia and adjacent segment disease occurred most often, but were deemed acceptable complications. Although surgeon experience and primary specialty had little impact on responses, practice location was found to significantly influence responses for 12 of 18 complications, with non-US surgeons found to categorize events more toward the uncommon and unacceptable end of the spectrum as compared with US surgeons. CONCLUSIONS: These results serve to aid communication and transparency within the field of spine surgery, and will help to inform future quality improvement and best practice initiatives.
PURPOSE: Anterior cervical discectomy and fusion has a low but well-established profile of adverse events. The goal of this study was to gauge surgeon opinion regarding the frequency and acceptability of these events. METHODS: A 2-page survey was distributed to attendees at the 2015 Cervical Spine Research Society (CSRS) meeting. Respondents were asked to categorize 18 anterior cervical discectomy and fusion-related adverse events as either: "common and acceptable," "uncommon and acceptable," "uncommon and sometimes acceptable," or "uncommon and unacceptable." Results were compiled to generate the relative frequency of these responses for each complication. Responses for each complication event were also compared between respondents based on practice location (US vs. non-US), primary specialty (orthopedics vs. neurosurgery) and years in practice. RESULTS: Of 150 surveys distributed, 115 responses were received (76.7% response rate), with the majority of respondents found to be US-based (71.3%) orthopedic surgeons (82.6%). Wrong level surgery, esophageal injury, retained drain, and spinal cord injury were considered by most to be unacceptable and uncommon complications. Dysphagia and adjacent segment disease occurred most often, but were deemed acceptable complications. Although surgeon experience and primary specialty had little impact on responses, practice location was found to significantly influence responses for 12 of 18 complications, with non-US surgeons found to categorize events more toward the uncommon and unacceptable end of the spectrum as compared with US surgeons. CONCLUSIONS: These results serve to aid communication and transparency within the field of spine surgery, and will help to inform future quality improvement and best practice initiatives.