Orthopedist vs. neurosurgeon for elective spine surgeries: Does it make a difference?


A study published in Spine examines how surgeon specialty impacts elective spine surgery outcomes.

The researchers analyzed data from the American College of Surgeons National Surgical Quality Improvement Project Database. There were 50,361 patients included in the study. Neurosurgeons performed surgery on 66 percent; the remaining were treated by an orthopedic surgeon.


Here are five key findings from the study:


1. The only differences between the surgical subspecialties were diagnosis and outcomes.


2. When orthopedic surgeons performed the elective spine surgeries, patients were twice as likely to have a prolonged hospital length of stay as when neurosurgeons were performing the procedure. Even after matching patients on propensity scores, patients treated by orthopedic surgeons had slightly higher odds of longer length of stay.


3. Patients who underwent treatment by orthopedic surgeons were also more likely to:


•    Receive a perioperative transfusion
•    Have complications
•    Require discharge with continued care


After matching patients, those treated by orthopedic surgeons were at twice the odds for receiving perioperative transfusions when compared with the neurosurgeons' patients.


4. The difference in length of stay remained even when taking perioperative transfusions into account.


5. However, differences in 30-day postoperative outcomes were minimal. "Analysis of a large, multi-institutional sample of prospectively collected clinical data suggests that surgeon specialty has limited influence on short-term outcomes after elective spine surgery," concluded the study authors.


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