PMID- 30694391
OWN - NLM
STAT- MEDLINE
DCOM- 20200708
LR  - 20200708
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 28
IP  - 4
DP  - 2019 Apr
TI  - Surgical training in spine surgery: safety and patient-rated outcome.
PG  - 807-816
LID - 10.1007/s00586-019-05883-9 [doi]
AB  - PURPOSE: The aim of this study was to investigate the difference in 
      patient-reported outcomes and surgical complication rates between lumbar 
      procedures carried out either by experienced board-certified spine surgeons (BCS) 
      or by supervised spine surgery residents (RES) in a large Swiss teaching 
      hospital. METHODS: This was a single-center retrospective analysis of data 
      collected prospectively within the framework of the EUROSPINE Spine Tango 
      Registry. It involved the data of 1415 patients undergoing first-time surgery in 
      our institution between the years 2004 and 2016. Patients were divided into three 
      groups based on the surgical procedure: lumbar single-level fusion (SLF), 
      single-level decompression (SLD) for lumbar spinal stenosis and disc hernia 
      procedures (DH). Patient-reported outcome measures (primary outcome) included the 
      multidimensional Core Outcome Measures Index (COMI) preoperatively and 3 and 
      12 months postoperatively plus single items concerning satisfaction with care and 
      global treatment outcome (GTO). Secondary outcomes included surgical variables 
      such as blood loss, duration of surgery, complication rates and length of stay. 
      RESULTS: There were no significant differences between the RES and BCS patient 
      groups for most of the demographic and baseline clinical variables with the 
      exception of age in the SLD group (p = 0.012), BMI in the DH group (p = 0.02) and 
      leg pain in the SLF group (p = 0.03). COMI scores improved significantly after 
      all three types of procedure (p < 0.0001) without significant difference 
      (p > 0.05) between the patients of RES and BCS. There was no significant 
      difference (p > 0.05) between RES and BCS patients with regard to satisfaction 
      and GTO. There were no significant differences between RES and BCS (p > 0.05) in 
      the surgical or medical complication rates. CONCLUSION: In the given setting, 
      surgical training of spine surgery residents under guided supervision by 
      board-certified spine surgeons was shown to be safe, as it was not associated 
      with greater morbidity or mortality. Furthermore, it had no detrimental influence 
      on patient-reported outcomes. The findings can be used to give reassurance to 
      prospective patients that are to be operated on by supervised spine surgery 
      residents. These slides can be retrieved under Electronic Supplementary Material.
FAU - Waisbrod, Guy
AU  - Waisbrod G
AUID- ORCID: 0000-0001-8953-2262
AD  - Spine Surgery Unit, Department of Spine and Orthopaedic Surgery, Swiss Paraplegic 
      Center, Guido-Zach-Strasse 1, 6207, Nottwil, Switzerland. 
      guy.waisbrod@paraplegie.ch.
FAU - Mannion, Anne F
AU  - Mannion AF
AD  - Spine Unit, Department of Spine Surgery, Schulthess Clinic, Lengghalde 2, 8008, 
      Zurich, Switzerland.
FAU - Fekete, Tamas F
AU  - Fekete TF
AD  - Spine Unit, Department of Spine Surgery, Schulthess Clinic, Lengghalde 2, 8008, 
      Zurich, Switzerland.
FAU - Kleinstueck, Frank
AU  - Kleinstueck F
AD  - Spine Unit, Department of Spine Surgery, Schulthess Clinic, Lengghalde 2, 8008, 
      Zurich, Switzerland.
FAU - Jeszenszky, Deszo
AU  - Jeszenszky D
AD  - Spine Unit, Department of Spine Surgery, Schulthess Clinic, Lengghalde 2, 8008, 
      Zurich, Switzerland.
FAU - Haschtmann, Daniel
AU  - Haschtmann D
AD  - Spine Unit, Department of Spine Surgery, Schulthess Clinic, Lengghalde 2, 8008, 
      Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20190129
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Blood Loss, Surgical/statistics & numerical data
MH  - Decompression, Surgical/*education
MH  - Education, Medical, Continuing/*standards
MH  - Female
MH  - Humans
MH  - Intervertebral Disc Displacement/*surgery
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Outcome Assessment, Health Care/*methods
MH  - Pain/surgery
MH  - Patient Reported Outcome Measures
MH  - Patient Satisfaction
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - Spinal Diseases/*surgery
MH  - Spinal Fusion/*education
OTO - NOTNLM
OT  - Complications spine surgery
OT  - Lumbar spine surgery
OT  - Patient-reported outcome
OT  - Surgical training
EDAT- 2019/01/30 06:00
MHDA- 2020/07/09 06:00
CRDT- 2019/01/30 06:00
PHST- 2018/07/02 00:00 [received]
PHST- 2019/01/11 00:00 [accepted]
PHST- 2019/01/30 06:00 [pubmed]
PHST- 2020/07/09 06:00 [medline]
PHST- 2019/01/30 06:00 [entrez]
AID - 10.1007/s00586-019-05883-9 [pii]
AID - 10.1007/s00586-019-05883-9 [doi]
PST - ppublish
SO  - Eur Spine J. 2019 Apr;28(4):807-816. doi: 10.1007/s00586-019-05883-9. Epub 2019 
      Jan 29.