Single Event Multilevel Surgery (SEMLS) for Children With Cerebral Palsy (CP)-Does Adding a Second Surgeon Make a...

Area of Science:

• Orthopedic Surgery
• Pediatric Surgery
• Neurosurgery

Background:

• Single-event multilevel surgery (SEMLS) is standard care for pediatric cerebral palsy (CP).
• The impact of dual-attending surgeons on SEMLS outcomes is understudied.
• This study evaluates dual-surgeon effects on resource use and patient outcomes in pediatric CP surgery.

Purpose of the Study:

• To compare resource utilization and postoperative outcomes between single and dual-attending surgeons in pediatric SEMLS.
• To identify specific patient subgroups benefiting from a dual-surgeon approach.
• To analyze the efficiency and cost-effectiveness of dual-surgeon SEMLS.

Main Methods:

• Retrospective review of 70 pediatric patients (<20 years) undergoing SEMLS.
• Comparison of single-surgeon (n=40) versus dual-surgeon (n=30) cohorts.
• Statistical analyses included t tests, Mann-Whitney U, chi-squared, and multivariable regression.

Main Results:

• Dual-surgeon cohort had higher rates of seizure history and revision procedures.
• Dual surgeons significantly decreased operative time (50 min avg. reduction), total blood loss, and operating room costs.
• Reductions were most pronounced in GMFCS IV/V patients and those undergoing hip reconstruction.
• No significant differences in complication rates, unplanned visits, or re-operations were observed.

Conclusions:

• A two-surgeon team for SEMLS enhances surgical efficiency.
• Dual-surgeon approach leads to decreased operative time, blood loss, and OR costs.
• This model is particularly beneficial for complex cases like hip reconstruction and in patients with higher GMFCS levels.