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Utilizing two surgeons for neuromuscular scoliosis suggests improved operative efficiency

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Abstract

Purpose

Neuromuscular scoliosis (NMS) patients tend to have significant comorbidities with complex medical and surgical histories. When undergoing posterior spinal fusion (PSF), NMS risks can be much higher than the idiopathic population. This study aimed to identify the impact of two experienced pediatric cosurgeons (CS) compared to a single spine surgeon (SS) on the intra- and postoperative results of NMS PSF.

Methods

A database of NMS patients who had undergone PSF 2016–2021 identified 53 patients, of which 32 were CS, while 21 were SS. Patients’ sex, age, weight, diagnosis, curve severity, fusion performed, estimated blood loss (EBL), transfusion rates, hemoglobin, anesthesia and surgical times, length of stay, and complications were collected.

Results

Patient demographics were similar between groups. Curves were more severe in the CS group (p = 0.013). Intraoperatively, CS patients underwent larger corrections (p = 0.089) but in significantly shorter anesthetic (p = 0.0018) and operative (p = 0.0025) times. Blood loss and transfusions were similar. Postoperatively, intensive-care unit (ICU) admission and length of stay (LOS) were similar, but SS had higher rates of both unplanned ICU admissions (p = 0.36) and 30 day readmissions (p = 0.053). Complications overall were similar between the groups both within 30 days (p = 0.40) and in the short-term period (31–90 days, p = 0.76), though the CS cohort had less Grade 2 immediate postoperative pulmonary complications (p = 0.16).

Conclusion

Utilizing CS for NMS PSF has been found to reduce operative times. Downstream, additional potential impacts trended toward fewer unplanned ICU admissions, less-frequent postoperative pulmonary complications, and reduced 30-day readmission rates.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, BM.

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Funding

No funding was received for this project.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA

    Bryan Menapace

  2. Department of Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    James McCarthy, Lindsay Schultz, Nichole Leitsinger, Viral Jain & Peter Sturm

Authors
  1. Bryan Menapace
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  2. James McCarthy
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  3. Lindsay Schultz
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  4. Nichole Leitsinger
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  5. Viral Jain
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  6. Peter Sturm
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Contributions

BM: made substantial contributions to the conception or design of the work and made substantial contributions to the acquisition, analysis, or interpretation of data; drafted the work and revised it critically for important intellectual content; approved the version to be published; agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JMC, LS, NL, VJ, and PS: made substantial contributions to the conception or design of the work; revised the work critically for important intellectual content; approved the version to be published; agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Bryan Menapace.

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Conflict of interest

Menapace: None, McCarthy: Orthopediatrics, speaker, Schultz: None, Leitsinger: None, Jain: None, Sturm: Nuvasive and green sun medical shareholder advisory board.

Ethical approval

This research study was conducted retrospectively from data obtained for research purposes. We consulted extensively with the IRB of Cincinnati Children’s Hospital Medical Center who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB at Cincinnati Children’s Hospital Medical Center.

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It is not needed due to retrospective study.

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Menapace, B., McCarthy, J., Schultz, L. et al. Utilizing two surgeons for neuromuscular scoliosis suggests improved operative efficiency. Spine Deform 11, 985–992 (2023). https://doi.org/10.1007/s43390-023-00678-x

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  • DOI: https://doi.org/10.1007/s43390-023-00678-x

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