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European Spine Journal
Published in: European Spine Journal 3/2018

01-03-2018 | Review

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

Authors: Azeem Tariq Malik, Usman Younis Panni, Muhammad Usman Mirza, Maryam Tetlay, Shahryar Noordin

Published in: European Spine Journal | Issue 3/2018

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Abstract

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.

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).

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.

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.
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Metadata
Title
The impact of surgeon volume on patient outcome in spine surgery: a systematic review
Authors
Azeem Tariq Malik
Usman Younis Panni
Muhammad Usman Mirza
Maryam Tetlay
Shahryar Noordin
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 3/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-5447-2

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