• World Neurosurg · Oct 2018

    Lumbar Discectomy Outcomes by Specialty: A Propensity-Matched Analysis of 7464 Patients from the ACS-NSQIP Database.

    • Darian R Esfahani, Harsh Shah, Gregory D Arnone, Justin K Scheer, and Ankit I Mehta.
    • Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
    • World Neurosurg. 2018 Oct 1; 118: e865-e870.

    ObjectiveTo investigate the influence of surgeon specialty on 30-day postoperative complication rates for single-level lumbar discectomies.MethodsAll patients who underwent single-level lumbar discectomy between 2005 and 2014 were reviewed from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Propensity score matching and univariate binary regression was used to determine whether surgeon subspecialty had an influence on 30-day postoperative complications.ResultsOf the 28,863 patients who underwent single-level lumbar discectomies during 2005-2014, 12,659 patients met inclusion criteria. Orthopedic surgeons performed 3733 operations (29.4%), and neurosurgeons performed 8926 operations (70.6%). A propensity-score matched sample of 7464 total cases (3732 orthopedic surgeon, 3732 neurosurgeon) was analyzed for the effect of surgeon specialty on 30-day outcomes. After propensity matching, orthopedic surgeons and neurosurgeons were similar in all postoperative outcomes, except for a slightly higher frequency of blood transfusions (0.3%, n = 11) in orthopedic versus neurosurgery patients (0.1%, n = 3; P = 0.032), although this did not remain significant after Bonferroni adjustment. Mean operative time was slightly longer for neurosurgeons (83.7 minutes) versus orthopedic surgeons (72.5 minutes; P < 0.001). There were no significant differences in mortality, readmission, or reoperation rates.ConclusionsSingle-level lumbar discectomies hold a low complication profile and show equivalent outcomes for both orthopedic and neurological surgeons, although neurosurgeons may exhibit a slightly longer mean operative time. In propensity score-matched cohorts, orthopedic surgeons had slightly higher rates of blood transfusions, although the number was small and did not remain significant after Bonferroni adjustment.Copyright © 2018 Elsevier Inc. All rights reserved.

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