Unnecessary lumbar spine surgeries dwindle with multidisciplinary review —5 takeaways

Spine

Seattle-based Virginia Mason Medical Center researchers presented a study on the impact of multidisciplinary review on lumbar spine surgeries at the American Association of Neurological Surgeons Annual Meeting, held from April 22 to April 26 in Los Angeles, according to Medscape.

In the past three decades, lumbar spine surgery has increased eight-fold, so researchers are investigating whether surgery provides better outcomes than non-operative care.

 

The study included 100 patients recommended for spinal fusion by outside spine surgeons or possessed complex histories of previous spine surgery.

 

Spine published the study.

 

Here are five takeaways:

 

1. First author Vijay Yanamadala, MD, spoke to the benefits of a multidisciplinary specialist team reviewing patients scheduled for lumbar spine surgery. At Virginia Mason, multidisciplinary specialist teams include anesthesiologists, pain specialists, rehabilitation specialists, neurosurgeons, orthopedic spine surgeons, physical and occupational therapists and nursing staff.

 

2. The study authors found 58 percent of cases initially recommended for spine surgery by an outside surgeon were steered toward nonsurgical approaches following multidisciplinary review.

 

3. The multidisciplinary team considered a variety of factors that led to decisions of nonsurgical care, such as misdiagnosis and contraindications.

 

4. Twenty-eight percent of patients received revised surgical treatment plans, following multidisciplinary review. Researchers reported no 30-or 90-day complications for performed surgeries as well as no 90-day readmissions.

 

5. Researchers emphasized the issue at play is not a lack of training, but rather the result of isolated decision making.

 

Dr. Yanamadala told Medscape Medical News, multidisciplinary review yields "superior care, better patient satisfaction and better outcomes."

 

 

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