Dual vs. single surgeon in spinal deformity correction: a meta-analysis

Area of Science:

• Orthopedic Surgery
• Spinal Deformity Correction
• Surgical Outcomes Research

Background:

• Spinal deformity correction is a complex procedure with risks of prolonged operative time, significant blood loss, and complications.
• Dual-attending surgeon (DS) models are explored to improve efficiency and safety, but evidence is inconsistent.

Purpose of the Study:

• To compare the perioperative and postoperative outcomes of dual-attending surgeon (DS) versus single-attending surgeon (SS) strategies in spinal deformity surgery.

Main Methods:

• A meta-analysis of 17 comparative studies evaluating DS versus SS procedures for spinal deformity correction.
• Systematic literature search conducted across major databases (PubMed, Scopus, Cochrane Library, Google Scholar) up to November 2025.
• Outcomes assessed included operative time, blood loss, transfusion needs, hospital stay, radiographic correction (Cobb angle), complications, readmissions, and revisions.

Main Results:

• The DS approach demonstrated significantly reduced operative time (mean difference -109.69 min), intraoperative blood loss (mean difference -308.90 mL), and hospital length of stay (mean difference -0.99 days).
• DS cases showed a significantly lower risk of transfusion (RR 0.11).
• No significant differences were found in Cobb angle correction, readmission rates, revision rates, or overall complication rates between DS and SS groups.

Conclusions:

• The dual-attending surgeon (DS) strategy enhances operative efficiency and reduces perioperative blood loss and transfusion requirements in spinal deformity surgery.
• DS maintains equivalent radiographic correction and comparable postoperative outcomes to the single-attending surgeon (SS) model.
• Selective use of DS is recommended for complex or high-risk cases; further prospective studies are needed for long-term value and cost-effectiveness.