Routine imaging for elective lumbar spine surgery: a questionnaire study.
| Autor: | Bohl DD; Yale School of Medicine, New Haven, CT 06510, USA., Ruiz FK, Webb ML, Gruskay JA, Grauer JN |
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| Jazyk: | angličtina |
| Zdroj: | Spine [Spine (Phila Pa 1976)] 2013 Jun 15; Vol. 38 (14), pp. 1233-7. |
| DOI: | 10.1097/BRS.0b013e31828cb001 |
| Abstrakt: | Study Design: Cross-sectional, questionnaire study. Objective: To characterize imaging practices for 3 common lumbar spine procedures. Summary of Background Data: As lumbar surgical procedures are performed with increasing frequency, it becomes incrementally more important to optimize patient care, minimize risk, and reduce associated costs. Imaging is an area for potential improvement; however, little has been done to characterize current imaging practices, compare imaging practices with current evidence, or establish a standard of care. Methods: We distributed a single-page questionnaire to all attending spine surgeons at a United States spine conference (The Spine Study Group) in 2012. Results: Forty-one of 74 surgeons (55.4%) completed and returned the questionnaire. All results are given for posterior lumbar decompression, posterior lumbar fusion, and anterior lumbar fusion, respectively.Intraoperatively, 75%, 90%, and 95% of surgeons use fluoroscopy, whereas 25%, 10%, and 5% use plain film; 80%, 59%, and 54% take images prior to skin incision; 59%, 98%, and 100% always take final images at the end of the procedure while still in the operating room. Postoperatively, 13%, 54%, and 54% of surgeons take images after patients have left the operating room but before they have been discharged. Interestingly, 10%, 50%, and 51% of surgeons not only take intraoperative images of their final constructs, but also take additional images before discharge.Surgeons follow their postoperative outpatients with imaging for a mean of 0.4, 1.5, and 1.5 years. Fifty-four percent, 98%, and 100% follow with anterior-posterior views; 56%, 93%, and 95% with lateral views; and 15%, 39%, and 39% with flexion-extension films. For both anterior and posterior fusion, 26% routinely follow with computed tomographic scan to assess fusion. Conclusion: Findings highlight extreme variability in practice associated with a notable lack of standard of care and provide a baseline for utility studies that may lead to more evidence-driven care. |
| Databáze: | MEDLINE |
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