Spine surgeon specialty is not a risk factor for 30-day complication rates in single-level lumbar fusion: a propensity score-matched study of 2528 patients. Spine (Phila Pa 1976) 2014 Jul 01;39(15):E919-27
Date
05/16/2014Pubmed ID
24827522DOI
10.1097/BRS.0000000000000394Scopus ID
2-s2.0-84926186078 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
STUDY DESIGN: Multicenter retrospective cohort study.
OBJECTIVE: To investigate the impact of spine surgeon specialty on 30-day complication rates in patients undergoing single-level lumbar fusion.
SUMMARY OF BACKGROUND DATA: Operative care of the spine is delivered by surgeons who undergo either orthopedic or neurosurgical training. It is currently unknown whether surgeon specialty has an impact on 30-day complication rates in patients undergoing single-level lumbar fusion.
METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was retrospectively reviewed to identify all patients who underwent single-level lumbar fusion procedures during 2006-2011. Propensity score matching analysis was employed to reduce baseline differences in patient characteristics. Univariate and multivariate analyses were performed to assess the impact of spine surgeon specialty on 30-day complication rates.
RESULTS: A total of 2970 patients were included for analysis. After propensity matching, 1264 pairs of well-matched patients remained in the cohort. Overall complication rates in the unadjusted data set were 7.3% and 7.1% for the neurosurgery and orthopedic surgery cohort, respectively. Our multivariate analysis revealed that compared with the neurosurgery cohort, the orthopedic surgery cohort did not have statistically significant differences in odds ratios (OR) for development of any complication (OR, 0.95; 95% confidence interval [CI], 0.69-1.30; P = 0.740). Similarly, spine surgeon specialty was not a risk factor in any of the specific complications studied, including medical complications (OR, 1.11; 95% CI, 0.77-1.60; P = 0.583), surgical complications (OR, 0.76; 95% CI, 0.46-1.26; P = 0.287), or reoperation (OR, 1.10; 95% CI, 0.76-1.60; P = 0.618).
CONCLUSION: Our analysis demonstrates that spine surgeon specialty is not a risk factor for any of the reported 30-day complications in patients undergoing single-level lumbar fusion. These data support the currently dichotomous paradigm of training for spine surgeons. Further research is warranted to validate this relationship in other spine procedures and for other outcomes.
LEVEL OF EVIDENCE: 4.
Author List
Kim BD, Edelstein AI, Hsu WK, Lim S, Kim JYMESH terms used to index this publication - Major topics in bold
AdultAged
Databases, Factual
Female
Humans
Lumbar Vertebrae
Male
Middle Aged
Multivariate Analysis
Neurosurgery
Neurosurgical Procedures
Orthopedic Procedures
Orthopedics
Postoperative Complications
Propensity Score
Retrospective Studies
Risk Factors
Spinal Fusion
Surgeons
Time Factors