Spine Surgical Subspecialty and Its Effect on Patient Outcomes: A Systematic Review and Meta-Analysis.

dc.contributor.author

Lambrechts, Mark J

dc.contributor.author

Canseco, Jose A

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Toci, Gregory R

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Karamian, Brian A

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Kepler, Christopher K

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Smith, Michael L

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Schroeder, Gregory D

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Hilibrand, Alan S

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Heller, Joshua E

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Grasso, Giovanni

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Gottfried, Oren

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Kebaish, Khaled M

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Harrop, James S

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Shaffrey, Christopher

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Vaccaro, Alexander R

dc.date.accessioned

2023-06-13T22:50:18Z

dc.date.available

2023-06-13T22:50:18Z

dc.date.issued

2023-05

dc.date.updated

2023-06-13T22:50:17Z

dc.description.abstract

Study design

Systematic review and meta-analysis.

Objective

To perform a systematic review and meta-analysis to identify if intraoperative or postoperative differences in outcomes exist between orthopedic and neurological spine surgeons.

Summary of background data

Spine surgeons may become board certified through orthopedic surgery or neurosurgical residency training, and recent literature has compared surgical outcomes between surgeons based on residency training background with conflicting results.

Materials and methods

Using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a search of PubMed and Scopus databases was conducted and included articles comparing outcomes between orthopedic spine surgeons and neurosurgeons. The Newcastle-Ottawa scale was used to determine the quality of studies. Forest plots were generated using mean differences (MD) for continuous variables and odds ratios (OR) for binomial variables, and 95% CI was reported.

Results

Of 615 search term results, 16 studies were identified for inclusion. Evaluation of the studies found no differences in readmission rates [OR, ref: orthopedics: 0.99 (95% CI: 0.901, 1.09); I2 = 80%], overall complication rates [OR, ref: orthopedics: 1.03 (95% CI: 0.97, 1.10); I2 = 70%], reoperation rates [OR, ref: orthopedics: 0.91 (95% CI: 0.82, 1.00); I2 = 86%], or overall length of hospital stay between orthopedic spine surgeons and neurosurgeons [MD: -0.19 days (95% CI: -0.38, 0.00); I2 = 98%]. However, neurosurgeons ordered a significantly lower rate of postoperative blood transfusions [OR, ref: orthopedics: 0.49 (95% CI: 0.41, 0.57); I2 = 75%] while orthopedic spine surgeons had shorter operative times [MD: 14.28 minutes, (95% CI: 8.07, 20.49), I2 = 97%].

Conclusions

Although there is significant data heterogeneity, our meta-analysis found that neurosurgeons and orthopedic spine surgeons have similar readmission, complication, and reoperation rates regardless of the type of spine surgery performed.
dc.identifier

00007632-990000000-00250

dc.identifier.issn

0362-2436

dc.identifier.issn

1528-1159

dc.identifier.uri

https://hdl.handle.net/10161/27929

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Spine

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10.1097/brs.0000000000004554

dc.subject

Spine

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Humans

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Orthopedic Procedures

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Neurosurgical Procedures

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Surgeons

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Neurosurgeons

dc.title

Spine Surgical Subspecialty and Its Effect on Patient Outcomes: A Systematic Review and Meta-Analysis.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher|0000-0001-9760-8386

pubs.begin-page

625

pubs.end-page

635

pubs.issue

9

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

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Clinical Science Departments

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Orthopaedic Surgery

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Neurosurgery

pubs.publication-status

Published

pubs.volume

48

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