Surgical training in spine surgery: safety and patient-rated outcome
| Autor: | Daniel Haschtmann, Tamas F. Fekete, Guy Waisbrod, Anne F. Mannion, Frank S. Kleinstueck, Deszö Jeszenszky |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Decompression Operative Time Blood Loss Surgical Pain Klinikai orvostudományok 03 medical and health sciences 0302 clinical medicine Lumbar Postoperative Complications Outcome Assessment Health Care medicine Humans Orthopedics and Sports Medicine Patient Reported Outcome Measures Aged Retrospective Studies Aged 80 and over 030222 orthopedics Core (anatomy) Analysis of Variance Lumbar Vertebrae business.industry Lumbar spinal stenosis Orvostudományok Middle Aged medicine.disease Decompression Surgical Surgical training Surgery Spinal Fusion Patient Satisfaction Patient-reported outcome Education Medical Continuing Female Spinal Diseases Neurosurgery business Complication 030217 neurology & neurosurgery Intervertebral Disc Displacement |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 28(4) |
| ISSN: | 1432-0932 |
| Popis: | The aim of this study was to investigate the difference in patient-reported outcomes and surgical complication rates between lumbar procedures carried out either by experienced board-certified spine surgeons (BCS) or by supervised spine surgery residents (RES) in a large Swiss teaching hospital.This was a single-center retrospective analysis of data collected prospectively within the framework of the EUROSPINE Spine Tango Registry. It involved the data of 1415 patients undergoing first-time surgery in our institution between the years 2004 and 2016. Patients were divided into three groups based on the surgical procedure: lumbar single-level fusion (SLF), single-level decompression (SLD) for lumbar spinal stenosis and disc hernia procedures (DH). Patient-reported outcome measures (primary outcome) included the multidimensional Core Outcome Measures Index (COMI) preoperatively and 3 and 12 months postoperatively plus single items concerning satisfaction with care and global treatment outcome (GTO). Secondary outcomes included surgical variables such as blood loss, duration of surgery, complication rates and length of stay.There were no significant differences between the RES and BCS patient groups for most of the demographic and baseline clinical variables with the exception of age in the SLD group (p = 0.012), BMI in the DH group (p = 0.02) and leg pain in the SLF group (p = 0.03). COMI scores improved significantly after all three types of procedure (p 0.0001) without significant difference (p 0.05) between the patients of RES and BCS. There was no significant difference (p 0.05) between RES and BCS patients with regard to satisfaction and GTO. There were no significant differences between RES and BCS (p 0.05) in the surgical or medical complication rates.In the given setting, surgical training of spine surgery residents under guided supervision by board-certified spine surgeons was shown to be safe, as it was not associated with greater morbidity or mortality. Furthermore, it had no detrimental influence on patient-reported outcomes. The findings can be used to give reassurance to prospective patients that are to be operated on by supervised spine surgery residents. These slides can be retrieved under Electronic Supplementary Material. |
| Databáze: | OpenAIRE |
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