A scoping review of spine surgeries between specialties: comparing neurosurgeons versus orthopedic surgeons
DOI:
https://doi.org/10.18203/2320-6012.ijrms20233416Keywords:
Spine surgery, Spine surgeon specialty, Neurosurgeon, Orthopedic surgeonAbstract
Spine surgeries are both performed by neurosurgeons and orthopedic surgeons. However, there remains controversy whether surgeon specialty affects spine surgery outcomes and complications. The objective of this scoping review was to map the existing knowledge comparing the outcomes and complications of spine surgeries between neurosurgeons and orthopedic surgeons. Eligible studies are any English-written or -translated published journals written from year 2000 onwards that compared outcomes and/or complications of spine surgeries between neurosurgeons and orthopedic surgeons. Excluded papers are those which do not dichotomize or specify the surgeon specialty to either neurosurgeon or orthopedic surgeon. Medline database was used to systematically search for papers that compare the two specialties. Ten studies were selected which directly compared spine surgery outcomes of the two specialties, all of which are retrospective studies and most of it relied on the national database. Specific spine surgeries were varied between all studies. Overwhelmingly, these studies showed no significant differences between neurosurgeons and orthopedic surgeons in short term outcomes while there were some significant differences in complications. Based on this scoping study, surgeon specialty, whether neurosurgery or orthopedics, has no significant association in spine surgery outcomes. This may imply that despite the differences in training, patients may have good outcomes if treated by either specialty. However, questions remain whether the effect of further training after residency or fellowship, length of experience and number of cases of both surgeon specialties have a causal effect in outcomes of spine surgeries.
References
Bronheim RS, Cheung ZB, Phan K, White SJW, Kim JS, Cho SK. Anterior lumbar fusion: differences in patient selection and surgical outcomes between neurosurgeons and orthopaedic surgeons. World Neurosurg. 2018;120:221-6.
Baek J, Malik AT, Khan I, Yu E, Kim J, Khan SN. Orthopedic versus neurosurgery-understanding 90-day complications and costs in patients undergoing elective 1-level to 2-level posterior lumbar fusions by different specialties. World Neurosurg. 2019;131:447-53.
Seicean A, Alan N, Seicean S, Neuhauser D, Benzel EC, Weil RJ. Surgeon specialty and outcomes after elective spine surgery. Spine (Phila Pa 1976). 2014;39(19):1605-13.
Malige A, Yuh R, Yellapu V, Lands V, Woods B, Sokunbi G. Review of physician referrals to orthopedic spine versus neurosurgery. Clin Orthop Surg. 2020;12(1):55-9.
Malik AT, Baek J, Alexander JH, Khan SN, Scharschmidt TJ. Orthopaedic vs. neurosurgery - does a surgeon's specialty have an influence on 90-day complications following surgical intervention of spinal metastases? Clin Neurol Neurosurg. 2020;192:105735.
Mabud T, Norden J, Veeravagu A. Complications, readmissions, and revisions for spine procedures performed by orthopedic surgeons versus neurosurgeons: a retrospective, longitudinal study. Clin Spine Surg. 2017;30(10):1376-81.
Kim BD, Edelstein AI, Hsu WK, Lim S, Kim JY. Spine surgeon specialty is not a risk factor for 30-day complication rates in single-level lumbar fusion: a propensity score-matched study of 2528 patients. Spine (Phila Pa 1976). 2014;39(15):919-27.
Minhas SV, Chow I, Patel AA, Kim JY. Surgeon specialty differences in single-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976). 2014;39(20):1648-55.
Hu K, Liu M, Wang AJ. Spine surgeon specialty differences in single-level percutaneous kyphoplasty. BMC Surg. 2019;19(1):163.
McCutcheon BA, Ciacci JD, Marcus LP. Thirty-day perioperative outcomes in spinal fusion by specialty within the NSQIP Database. Spine (Phila Pa 1976). 2015;40(14):1122-31.
Hijji FY, Narain AS, Haws BE. Variation in spine surgeon selection criteria between neurosurgery and orthopedic surgery patients. Clin Spine Surg. 2018;31(2):127-32.
Daniels AH, Ames CP, Smith JS, Hart RA. Variability in spine surgery procedures performed during orthopaedic and neurological surgery residency training: an analysis of ACGME case log data. J Bone Joint Surg Am. 2014;96(23):196.
Pham MH, Jakoi AM, Wali AR, Lenke LG. Trends in spine surgery training during neurological and orthopaedic surgery residency. J Bone Joint Surg. 2019;101(22).
Alomari S, Lubelski D, Lo SFL. Surgeon specialty effect on early outcomes of elective posterior spinal fusion for adolescent idiopathic scoliosis: a propensity-matched analysis of 965 patients. Eur Spine J. 2022;31:2355-61.