Treatment of adult deformity surgery by orthopedic and neurological surgeons: trends in treatment, techniques, and costs by specialty

McDonald, Christopher L.; Berreta, Rodrigo A. Saad; Alsoof, Daniel; Homer, Alex; Molino, Janine; Ames, Christopher P.; Shaffrey, Christopher I.; Hamilton, D. Kojo; Diebo, Bassel G.; Kuris, Eren O.; Hart, Robert A.; Daniels, Alan H.

doi:10.1016/j.spinee.2023.05.012

Cited by 1 publication

(4 citation statements)

References 34 publications

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“…However, one study revealed that the patients operated by OS were found to belong to white ethnicity and constituted of higher proportion of males [ 61 ]. It was a consistent finding that patients being operated on by NS had many comorbidities [ 45 , 52 , 53 , 58 , 60 ]. The mean American Society of Anesthesiologists (ASA) class was found to be higher in patients who were being operated on by NS [ 45 , 50 , 53 , 54 ].…”

Section: Reviewmentioning

confidence: 82%

“…This study faced limitations due to intrinsic limitations in administrative databases, including the absence of necessary outcomes and conditions in medical records, and the lack of generalizability. The costing information was incomplete and misrepresented posing a pertinent challenge [ 60 ].…”

Section: Reviewmentioning

confidence: 99%

“…Some noteworthy differences were found among patient demographics treated by two specialties. It is observed that the patients operated on by NS tend to be older and functionally dependent compared to patients operated on by OS [ 45 , 52 , 60 ]. However, in a study conducted on isolated spinal fracture management, it was found that patients operated on by NS were younger and functionally independent [ 58 ].…”

Section: Reviewmentioning

confidence: 99%

“…It was found that procedures conducted by OS had significantly lower average costs for the procedure [ 56 , 60 ]. Perception of surgeon specialty and differences in instrumentation could be the factors contributing.…”

Section: Reviewmentioning

confidence: 99%

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Specialty Impact on Patient Outcomes: Paving a Way for an Integrated Approach to Spinal Disorders

Kuruba,

Cherukuri,

Arul

et al. 2023

Cureus

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Spinal surgical procedures are steadily increasing globally due to broad indications of certain techniques encompassing a wide spectrum of conditions, including degenerative spine disorders, congenital anomalies, spinal metastases, and traumatic spinal fractures. The two specialties, neurosurgery (NS) and orthopedic surgery (OS), both possess the clinical adeptness to perform these procedures. With the advancing focus on comparative effectiveness research, it is vital to compare patient outcomes in spine surgeries performed by orthopedic surgeons and neurosurgeons, given their distinct approaches and training backgrounds to guide hospital programs and physicians to consider surgeon specialty when making informed decisions. Our review of the available literature revealed no significant difference in postoperative outcomes in terms of blood loss, neurological deficit, dural injury, intraoperative complications, and postoperative wound dehiscence in procedures performed by neurosurgeons and orthopedic surgeons. An increase in blood transfusion rates among patients operated by orthopedic surgeons and a longer operative time of procedures performed by neurosurgeons was a consistent finding among several studies. Other findings include a prolonged hospital stay, higher hospital readmission rates, and lower cost of procedures in patients operated on by orthopedic surgeons. A few studies revealed lower sepsis rates unplanned intubation rates and higher incidence of urinary tract infections (UTIs) and pneumonia postoperatively among patient cohorts operated by neurosurgeons. Certain limitations were identified in the studies including the use of large databases with incomplete information related to patient and surgeon demographics. Hence, it is imperative to account for these confounding variables in future studies to alleviate any biases. Nevertheless, it is essential to embrace a multidisciplinary approach integrating the surgical expertise of the two specialties and develop standardized management guidelines and techniques for spinal disorders to mitigate complications and enhance patient outcomes.

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