The impact of surgeon volume on patient outcome in spine surgery: a systematic review.

MedStar author(s):
Citation: European Spine Journal. 27(3):530-542, 2018 03.PMID: 29344731Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Hospitals, High-Volume/sn [Statistics & Numerical Data] | *Orthopedic Procedures/sn [Statistics & Numerical Data] | *Spine/su [Surgery] | *Surgeons/sn [Statistics & Numerical Data] | Hospitalization/ec [Economics] | Humans | Length of Stay | Patient Readmission | Postoperative Complications | ReoperationYear: 2018ISSN:
  • 0940-6719
Name of journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research SocietyAbstract: CONCLUSIONS: Findings suggest a trend towards better outcomes for higher volume surgeons; however, further study needs to be carried out to define objective volume thresholds for individual spine surgeries for surgeons to use as a marker of proficiency.METHODS: We performed a systematic review examining the association between surgeon volume and spine surgery outcomes. To be included in the review, the study population had to include patients undergoing a primary or revision spinal procedure. These included anterior cervical discectomy and fusion (ACDF), anterior/posterior cervical fusion, laminectomy/decompression, anterior/posterior lumbar decompression with fusion, discectomy, and spinal deformity surgery (spine arthrodesis).PURPOSE: Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of surgeries to higher volume centers and adoption of volume standards. With limited literature promoting the regionalization of spine surgeries, we undertook a systematic review to investigate the impact of surgeon volume on outcomes in patients undergoing spine surgery.RESULTS: Studies were variable in defining surgeon volume thresholds. Higher surgeon volume was associated with a significantly lower risk of postoperative complications, a lower length of stay (LOS), lower cost of hospital stay and a lower risk of readmissions and reoperations/revisions.All authors: Malik AT, Mirza MU, Noordin S, Panni UY, Tetlay MFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2018-01-22
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Journal Article MedStar Authors Catalog Article 29344731 Available 29344731

CONCLUSIONS: Findings suggest a trend towards better outcomes for higher volume surgeons; however, further study needs to be carried out to define objective volume thresholds for individual spine surgeries for surgeons to use as a marker of proficiency.

METHODS: We performed a systematic review examining the association between surgeon volume and spine surgery outcomes. To be included in the review, the study population had to include patients undergoing a primary or revision spinal procedure. These included anterior cervical discectomy and fusion (ACDF), anterior/posterior cervical fusion, laminectomy/decompression, anterior/posterior lumbar decompression with fusion, discectomy, and spinal deformity surgery (spine arthrodesis).

PURPOSE: Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of surgeries to higher volume centers and adoption of volume standards. With limited literature promoting the regionalization of spine surgeries, we undertook a systematic review to investigate the impact of surgeon volume on outcomes in patients undergoing spine surgery.

RESULTS: Studies were variable in defining surgeon volume thresholds. Higher surgeon volume was associated with a significantly lower risk of postoperative complications, a lower length of stay (LOS), lower cost of hospital stay and a lower risk of readmissions and reoperations/revisions.

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