Are high-volume hospitals and surgeons better for spinal deformity surgery? 5 key notes

Written by Laura Dyrda | May 01, 2015 | Print  |

A study published in The Spine Journal examines the complication rates for revision adult spinal deformity surgery among high-volume hospitals and surgeons.

Researchers examined the Nationwide Inpatient Sample database from 2001 to 2010 for patients older than 21 years who underwent surgery for spine arthrodesis for scoliosis.


There were 139,150 cases and 4,888 revisions with hospital identifiers and 1,978 surgeon identifiers included in the study. The researchers found:


1. The higher volume surgeons performed more cases and revision cases that required osteotomy.


2. The higher-volume hospitals showed a 9.7 percent complication rate for RASDS, compared with 12.9 percent for low-volume centers.


3. The higher volume surgeons showed a significantly lower rate of complications — the higher volume surgeons reported 8.8 percent major complication rate for RASDS, compared with 10.7 percent for the lowest volume surgeons.


4. ASDS cases requiring osteotomy had similar complication trends.


5. Reoperation rates for infection and pseudoarthrosis/implant failure after RASDS were higher for low-volume hospitals and surgeons, according to data from the New York State Inpatient Database.


"As complex cases requiring osteotomy and combined approaches are more frequent at high-volume centers, an operative complexity index helps predict the likelihood of volume-dependent complication rates," concluded the study authors. "Further inter-hospital and inter-surgeon comparisons should account for these case characters so that similar case complexity is compared in these analyses."


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