The relationship between surgeon experience, complications, and radiographic outcomes in spine deformity surgery: the experience of a junior surgeon

Authors

Alexander G. Yearley, Harvard Medical School, Boston, MA 02115, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address: alexander_yearley@hms.harvard.edu.
Joshua I. Chalif, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
Eric J. Chalif, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA; George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia 20052 USA.
Hasan A. Zaidi, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address: hzaidi1@bwh.harvard.edu.

Document Type

Journal Article

Publication Date

10-25-2022

Journal

World neurosurgery

DOI

10.1016/j.wneu.2022.10.068

Keywords

adult spine deformity; complications; outcomes; surgeon experience

Abstract

OBJECTIVE: To examine complication rates and radiographic outcomes in patients undergoing surgery for adult spinal deformity by a junior surgeon. METHODS: A study was conducted of a retrospective cohort of patients who underwent an open posterior interbody fusion of the thoracic and/or lumbar regions by a single surgeon for adult spinal deformity (ASD) between 2018 and 2022. Patient characteristics, complications, and common radiographic parameters of spinopelvic alignment were collated. RESULTS: 112 patients with an average of 4.2 comorbidities underwent surgical correction of ASD. 37 patients (33.0%) experienced 52 major complications and 50 patients (44.6%) experienced 66 minor complications. 23 patients (20.5%) required a revision operation. Both sagittal vertical axis (p < 10) and pelvic incidence-lumbar lordosis mismatch (p < 10) significantly improved postoperatively. Number of levels (p < 0.05), operative time > 650 minutes (p < 0.01), estimated blood loss > 1500mL (p < 0.01), length of ICU stay > 1 day (p < 0.05), and hospitalization length > 5 days (p < 0.05) all significantly increased the risk of a major complication. No patient factors significantly increased the risk of minor complications or revision surgery. CONCLUSION: Observed complication and revision rates in this cohort were consistent with rates published in the literature. No pre-operative patient risk factors significantly increased risk of complications or need for revision, suggesting that no patient population is at increased risk undergoing surgery by a junior surgeon. The relatively high rate of complications observed in this cohort may be due to high baseline morbidity.

APA Citation

Yearley, Alexander G.; Chalif, Joshua I.; Chalif, Eric J.; and Zaidi, Hasan A., "The relationship between surgeon experience, complications, and radiographic outcomes in spine deformity surgery: the experience of a junior surgeon" (2022). GW Authored Works. Paper 1737.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1737

Department

School of Medicine and Health Sciences Student Works