Review of Physician Referrals to Orthopedic Spine versus Neurosurgery

Malige, Ajith; Yuh, Roger; Yellapu, Vikas; Lands, Vince W; Woods, Barrett I.; Sokunbi, Gbolabo

doi:10.4055/cios.2020.12.1.55

Cited by 6 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The scoping review had shown that complications for the two specialties are not statistically different. [1][2][3][4][5][6][7][8][9][10] However, there is still some variations in the complications between specialties (e.g., blood transfusions and dural tear). 3 These complications may reflect the differences in technique and case exposure.…”

Section: Discussionmentioning

confidence: 99%

“…In general, spine surgeries are performed by either of the two specialties: neurosurgery and orthopedics. [1][2][3][4][5][6][7][8][9][10] Despite the inherent differences in training pathway, there exists a significant overlap in the patient population and management by both specialties. 1 To date, several studies have attempted to compare spine surgeries between the two specialties.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A scoping review of spine surgeries between specialties: comparing neurosurgeons versus orthopedic surgeons

Trinidad,

Orata

2023

Int J Res Med Sci

View full text Add to dashboard Cite

Spine surgeries are both performed by neurosurgeons and orthopedic surgeons. However, there remains controversy whether surgeon specialty affects spine surgery outcomes and complications. The objective of this scoping review was to map the existing knowledge comparing the outcomes and complications of spine surgeries between neurosurgeons and orthopedic surgeons. Eligible studies are any English-written or -translated published journals written from year 2000 onwards that compared outcomes and/or complications of spine surgeries between neurosurgeons and orthopedic surgeons. Excluded papers are those which do not dichotomize or specify the surgeon specialty to either neurosurgeon or orthopedic surgeon. Medline database was used to systematically search for papers that compare the two specialties. Ten studies were selected which directly compared spine surgery outcomes of the two specialties, all of which are retrospective studies and most of it relied on the national database. Specific spine surgeries were varied between all studies. Overwhelmingly, these studies showed no significant differences between neurosurgeons and orthopedic surgeons in short term outcomes while there were some significant differences in complications. Based on this scoping study, surgeon specialty, whether neurosurgery or orthopedics, has no significant association in spine surgery outcomes. This may imply that despite the differences in training, patients may have good outcomes if treated by either specialty. However, questions remain whether the effect of further training after residency or fellowship, length of experience and number of cases of both surgeon specialties have a causal effect in outcomes of spine surgeries.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A scoping review of spine surgeries between specialties: comparing neurosurgeons versus orthopedic surgeons

Trinidad,

Orata

2023

Int J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…Los médicos de primer contacto tienen ciertos sesgos y patrones cuando se trata de referir un paciente con patología de columna vertebral con el especialista (falta de conocimiento o interés); estos sesgos y patrones pueden ser secundarios a experiencias personales con los cirujanos de columna con los que se han relacionado (falta de profesionalismo, rivalidad, egocentrismo, malas relaciones interpersonales), el acceso limitado a este tipo de especialistas, las campañas de marketing (la lumbalgia, al ser la segunda causa de consulta ortopédica, existe mucho marketing de manejos «alternativos»), las iniciativas o políticas del hospital donde laboren (patología de columna cervical sólo es atendida por neurocirujanos y patología de columna lumbar por ortopedistas), así como muchos otros factores. 7 La comunicación abierta, la educación acerca de capacidades y alcances del urgenciólogo, así como mejores relaciones entre los cirujanos de columna y los médicos de primer contacto podría ayudar a tener una adecuada referencia con el especialista en columna y ayudar a los pacientes independientemente de la patología. 7 La mayoría de los médicos de atención primaria se sienten «algo» preparados al comunicar el riesgo, así como para identificar los posibles casos de emergencia de la columna vertebral.…”

Section: Discussionunclassified

“…7 La comunicación abierta, la educación acerca de capacidades y alcances del urgenciólogo, así como mejores relaciones entre los cirujanos de columna y los médicos de primer contacto podría ayudar a tener una adecuada referencia con el especialista en columna y ayudar a los pacientes independientemente de la patología. 7 La mayoría de los médicos de atención primaria se sienten «algo» preparados al comunicar el riesgo, así como para identificar los posibles casos de emergencia de la columna vertebral. La mayoría de los médicos de primer contacto refirieron que usan como fuente de información y conocimiento su entrenamiento realizado en la escuela de medicina y/o el realizado en la residencia médica al enfrentarse a emergencias de columna vertebral.…”

Section: Discussionunclassified

Capacidad de los médicos en urgencias en detectar padecimientos de columna vertebral y solicitar valoración especializada

Olvera¹,

Oropeza²,

Flores³

et al. 2022

Revista CONAMED

View full text Add to dashboard Cite

Introducción: la mayoría de los padecimientos de la columna vertebral son abordados inicialmente por médicos de urgencias, así como médicos de primer contacto. Aunque la mayoría de estas patologías tiene orígenes benignos y autolimitados, alrededor de 5% tienen una causa severa, la cual de no tratarse puede tener un mal resultado secundario a un daño neurológico. Objetivo: el objetivo del estudio es identificar y analizar la capacidad del médico de urgencias de determinar la necesidad de una valoración por el especialista en padecimientos de la columna vertebral. Material y métodos: estudio observacional, transversal y retrospectivo llevado a cabo

show abstract

“…21 Finally, the last major surgeon factor affecting outcomes investigated in the literature is fellowship and specialty training. Despite studies showing different referral patterns, 22 complications and outcomes are reported to be similar between orthopedic and neurosurgery trained spine surgeons. A meta-analysis containing over 10,000 patients comparing outcomes between specialties only showed differences in incidence of wound complications and durotomies.…”

mentioning

confidence: 87%

Increased Surgeon-specific Experience and Volume is Correlated With Improved Clinical Outcomes in Lumbar Fusion Patients

Hines¹,

Philipp²,

Thalheimer³

et al. 2022

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

Study Design: The present study design was that of a single center, retrospective cohort study to evaluate the influence of surgeon-specific factors on patient functional outcomes at 6 months following lumbar fusion. Retrospective review of a prospectively maintained database of patients who underwent neurosurgical lumbar instrumented arthrodesis identified the present study population. Objective: This study seeks to evaluate surgeon-specific variable effects on patient-reported outcomes such as Oswestry Disability Index (ODI) and the effect of North American Spine Society (NASS) concordance on outcomes in the setting of variable surgeon characteristics. Summary of Background Data: Lumbar fusion is one of the fastest growing procedures performed in the United States. Although the impact of surgeon-specific factors on patient-reported outcomes has been contested, studies examining these effects are limited. Methods: This is a single center, retrospective cohort study analyzing a prospectively maintained database of patients who underwent neurosurgical lumbar instrumented arthrodesis by 1 of 5 neurosurgery fellowship trained spine surgeons. The primary outcome was improvement of ODI at 6 months postoperative follow-up compared with preoperative ODI. Results: A total of 307 patients were identified for analysis. Overall, 62% of the study population achieved minimum clinically important difference (MCID) in ODI score at 6 months. Years in practice and volume of lumbar fusions were statistically significant independent predictors of MCID ODI on multivariable logistic regression (P=0.0340 and P=0.0343, respectively). Concordance with evidence-based criteria conferred a 3.16 (95% CI: 1.03, 9.65) times greater odds of achieving MCID. Conclusion: This study demonstrates that traditional surgeon-specific variables predicting surgical morbidity such as experience and procedural volume are also predictors of achieving MCID 6 months postoperatively from lumbar fusion. Independent of surgeon factors, however, adhering to evidence-based guidelines can lead to improved outcomes.

show abstract

Review of Physician Referrals to Orthopedic Spine versus Neurosurgery

Cited by 6 publications

References 23 publications

A scoping review of spine surgeries between specialties: comparing neurosurgeons versus orthopedic surgeons

A scoping review of spine surgeries between specialties: comparing neurosurgeons versus orthopedic surgeons

Capacidad de los médicos en urgencias en detectar padecimientos de columna vertebral y solicitar valoración especializada

Increased Surgeon-specific Experience and Volume is Correlated With Improved Clinical Outcomes in Lumbar Fusion Patients

Contact Info

Product

Resources

About