Diversity in Surgical Decision Strategies for Adult Spine Deformity Treatment: The Effects of Neurosurgery or Orthopedic Training Background and Surgical Experience.
Abstract
This study is aimed to investigate whether surgical strategies for adult spinal deformity
(ASD) treatment differed among Korean physicians.This study is retrospective questionnaire-based
study. ASD is challenging to manage, with a broad range of clinical and radiological
presentations. To investigate possible nationality- or ethnicity-related differences
in the surgical strategies adopted for ASD treatment, the International Spine Study
Group surveyed physicians' responses to 16 cases of ASD. We reviewed the answers to
this survey from Korean physicians. Korean orthopedic surgeons (OS) and neurosurgeons
(NS) received a questionnaire containing 16 cases and response forms via email. After
reviewing the cases, physicians were asked to indicate whether they would treat each
case with decompression or fusion. If fusion was chosen, physicians were also asked
to indicate whether they would perform 3-column osteotomy. Retrospective chi-square
analyses were performed to investigate whether the answers to each question differed
according to training specialty or amount of surgical experience.Twenty-nine physicians
responded to our survey, of whom 12 were OS and 17 were NS. In addition, 18 (62.1%)
had more than 10 years of experience in ASD correction and were assigned to the M10
group, while 11 (37.9%) had less than 10 years of experience and were assigned to
the L10 group. We found that for all cases, the surgical strategies favored did not
significantly differ between OS and NS or between the M10 and L10 groups. However,
for both fusion surgery and 3-column osteotomy, opinions were divided regarding the
necessity of the procedures in 4 of the 16 cases.The surgical strategies favored by
physicians were similar for most cases regardless of their training specialty or experience.
This suggests that these factors do not affect the surgical strategies selected for
ASD treatment, with patient clinical and radiological characteristics having greater
importance.
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https://hdl.handle.net/10161/17579Published Version (Please cite this version)
10.14245/ns.1836086.043Publication Info
Kang, Jiin; Hosogane, Naobumi; Ames, Christopher; Schwab, Frank; Hart, Robert; Burton,
Douglas; ... Ha, Yoon (2018). Diversity in Surgical Decision Strategies for Adult Spine Deformity Treatment: The
Effects of Neurosurgery or Orthopedic Training Background and Surgical Experience.
Neurospine. 10.14245/ns.1836086.043. Retrieved from https://hdl.handle.net/10161/17579.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Christopher Ignatius Shaffrey
Professor of Orthopaedic Surgery
I have more than 25 years of experience treating patients of all ages with spinal
disorders. I have had an interest in the management of spinal disorders since starting
my medical education. I performed residencies in both orthopaedic surgery and neurosurgery
to gain a comprehensive understanding of the entire range of spinal disorders. My
goal has been to find innovative ways to manage the range of spinal conditions, straightforward
to complex. I have a focus on managing patients with complex s

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