Surgical Specialty Outcome Differences for Major Spinal Procedures in Low-Acuity Patients.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spine Surgery Outcomes

Background:

• Ongoing debate regarding specialty training influence on spine surgery outcomes.
• Previous research focused on specific procedures like ACDF, leaving gaps in analysis for other spine surgeries and lower-acuity cases.

Purpose of the Study:

• To compare outcomes of low American Society of Anesthesiologists (ASA) classification (ASA 1&2) patients undergoing spine surgery.
• To determine if outcomes vary between orthopedic surgeons and neurosurgeons for these patients.

Main Methods:

• Retrospective cohort study using the NSQIP database (2015-2021).
• Analysis of nine common spine procedures based on CPT codes.
• Comparison of surgical course indicators and outcomes between orthopedic and neurosurgical specialties.

Main Results:

• Neurosurgeons showed slightly shorter operative times and fewer perioperative transfusions in select ASA 1&2 groups.
• Orthopedic surgeons had shorter lengths of stay for cervical procedures in ASA 1&2 and ASA-1 patients.
• Specialty differences diminished when considering only ASA-1 patients.
• Postoperative complications and readmissions were similar between both specialties.

Conclusions:

• Statistically significant, yet clinically insignificant, differences were observed between orthopedic surgeons and neurosurgeons.
• Both specialties perform spinal surgery safely with comparable low complication rates.
• Findings support further research and performance benchmarking across neurosurgery and orthopedics.