PMID- 36006405
OWN - NLM
STAT- MEDLINE
DCOM- 20230301
LR  - 20230321
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 36
IP  - 2
DP  - 2023 Mar 1
TI  - Increased Surgeon-specific Experience and Volume is Correlated With Improved 
      Clinical Outcomes in Lumbar Fusion Patients.
PG  - E86-E93
LID - 10.1097/BSD.0000000000001377 [doi]
AB  - 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.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Hines, Kevin
AU  - Hines K
AD  - Department of Neurological Surgery, Thomas Jefferson University and Jefferson 
      Hospital for Neuroscience, Philadelphia, PA.
FAU - Philipp, Lucas
AU  - Philipp L
FAU - Thalheimer, Sara
AU  - Thalheimer S
FAU - Montenegro, Thiago S
AU  - Montenegro TS
FAU - Gonzalez, Glenn A
AU  - Gonzalez GA
FAU - Hughes, Liam P
AU  - Hughes LP
AUID- ORCID: 0000-0001-7900-5151
FAU - Leibold, Adam
AU  - Leibold A
FAU - Mahtabfar, Aria
AU  - Mahtabfar A
FAU - Franco, Daniel
AU  - Franco D
FAU - Heller, Joshua E
AU  - Heller JE
FAU - Jallo, Jack
AU  - Jallo J
FAU - Prasad, Srinivas
AU  - Prasad S
FAU - Sharan, Ashwini D
AU  - Sharan AD
FAU - Harrop, James S
AU  - Harrop JS
LA  - eng
PT  - Journal Article
DEP - 20220825
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Humans
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - Lumbar Vertebrae/surgery
MH  - Patient Reported Outcome Measures
MH  - *Surgeons
MH  - *Spinal Fusion/methods
COIS- The authors declare no conflict of interest.
EDAT- 2022/08/26 06:00
MHDA- 2023/03/03 06:00
CRDT- 2022/08/25 11:02
PHST- 2021/12/10 00:00 [received]
PHST- 2022/06/29 00:00 [accepted]
PHST- 2022/08/26 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2022/08/25 11:02 [entrez]
AID - 01933606-202303000-00011 [pii]
AID - 10.1097/BSD.0000000000001377 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2023 Mar 1;36(2):E86-E93. doi: 10.1097/BSD.0000000000001377. 
      Epub 2022 Aug 25.