A new study published in The Spine Journal examines the process of establishing benchmarks for lumbar spine surgery.
The study authors conducted a retrospective review of the Florida Statewide Inpatient Dataset for procedures that took place from 2011 to 2014 and measured complications and readmissions within the first 90 days of surgery. There were 187,185 spine surgeries that met inclusion criteria performed at 178 hospitals by 5,514 surgeons.
Study authors found:
1. Procedure volume cut points to create a categorical variable of the procedure volume were:
• Decompressions: 25
• Discectomy: 40
• Interbody fusion: 43
• Posterolateral fusion: 35
2. When surgeons didn't meet the volume criteria, they had a 63 percent increased risk of complications after decompressions. There was a 56 percent increase in the risk of complications after discectomy when surgeons didn't meet the cut-point.
3. Among fusion procedures, low-volume surgeons who didn't meet the cut point for lumbar interbody fusions experienced a 15 percent increase in the risk of complications, and the risk increased 47 percent for surgeons who didn't meet the volume cut-point for posterolateral fusions.
4. There was a similar trend for increased readmission rates for surgeons under the cut-point as there was for complication rate increases.
5. Study authors concluded, "Based on our determination, readily achievable goals for individual surgeons would approximate an average of four discectomy and lumbar interbody fusion procedures per month, three posterolateral lumbar fusions per month and at least one decompression surgery every other week."