Orthopedic vs. neurological residency: Which prepares more for spine surgery? 7 key notes

Written by Laura Dyrda | December 06, 2014 | Print  |

A study published in The Journal of Bone and Joint Surgery examines the spine procedures performed during orthopedic and neurological surgery residency training to find the variability.

The researchers used data from the Accreditation Council for Graduate Medical Education surgical case logs for graduating orthopedic surgery and neurosurgery residents from 2009 to 2012. They compared experience for both in spine surgery. Here are seven key findings from the study:


1. Orthopedic surgery residents experienced an average of 160 spine surgery procedures performed during their time. Neurosurgery residents experienced 275 spine procedures performed.


2. The average spine surgery case volume difference was 214.8 procedures, with a range of 196.3 procedures to 231.7 procedures. This is a significant difference.


3. Between 2009 and 2012, the number of spine surgeries orthopedic residents logged increased 24.3 percent. They logged 141 procedures on average in 2009 and 175.4 procedures on average in 2012.


4. Neurosurgery residents increased the number of logged spine surgeries 6.5 percent between 2009 and 2012. They logged an average of 367.9 spine procedures in 2009 and 391.8 procedures in 2012.


5. The number of spinal deformity procedures orthopedic surgery residents experienced was significantly higher than neurosurgery residents. Orthopedic surgery residents experienced an average of 9.5 spinal deformity procedures while their neurosurgery counterparts experienced an average of two spinal deformity procedures.


6. Spine surgery exposure experience is substantially variable for residents in both specialties. The researchers compared the top 10 percent and bottom 10 percent of graduates in 2012 for spinal instrumentation and arthrodesis procedures. They found:


• 13.1-fold difference for orthopedic surgery residents
• 8.3-fold difference for neurosurgery residents


7. Orthopedic spine fellowship training provides additional spine surgery case exposure of around 300 procedures to 500 procedures. "Thus, before entering independent practice, when compared with neurosurgery residents, most orthopedic spine surgeons complete as many spinal procedures or more," concluded the study authors. "Although case volume is not the sole determinant of surgical skills or clinical decision making, variability in spine surgery procedure volume does exist among residency programs in the United States."


More articles on spine surgery:
Dr. Jonathan Hyde joins Doctors Mobile Healthcare: 4 takeaways
10 spine surgeons, neurosugeons making the news this week
Not all spine databases are created equal: 5 key concepts

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