Spinal surgery: Who is in charge anyway?

Area of Science:

• Spine surgery
• Patient care coordination
• Multidisciplinary medical management

Background:

• Increasing burden on spine surgeons for comprehensive patient care, including preoperative and postoperative management.
• Lack of defined roles in managing patients with spinal disease.
• Spine surgeons are increasingly responsible for basic medical issues outside their core surgical expertise.

Purpose of the Study:

• To highlight the challenges spine surgeons face in managing complex patient care.
• To question the current model of care for spine surgery patients.
• To advocate for a clearer division of responsibilities in patient management.

Main Methods:

• Review of current practices in spine surgery patient care.
• Analysis of the scope of medical issues managed by spine surgeons.
• Discussion of the implications of current care models.

Main Results:

• Spine surgeons frequently manage comorbidities like hypertension and diabetes post-surgery.
• Medical colleagues often perform preoperative clearance but are disengaged from postoperative care.
• Spine surgeons are often left to manage all postoperative problems, acting as de facto primary care physicians.

Conclusions:

• The current system places an undue burden on spine surgeons for non-surgical patient management.
• There is a critical need to establish clear roles and responsibilities for preoperative and postoperative care in spine surgery.
• Without defined pathways, patient care may be compromised, and surgeons may be forced into roles beyond their training.