The value-added benefit of utilizing two attending surgeons for patients with scoliosis secondary to cerebral palsy

McDonald, Tyler; Gnam, Ashley; Brooks, Jaysson T.; Sukkarieh, Hamdi G.; Replogle, William H.; Wright, Patrick B.

doi:10.1007/s43390-021-00301-x

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…The benefits of dual surgeon operating have been documented extensively in the field of spinal surgery [14][15][16][17][18], but there is paucity of literature on its effects in shoulder surgery, and, specifically, with RGTSR. Dual surgeon operated spinal patients have been shown to have a shorted length of stay [16][17], and in an American spinal study, McDonald et al showed that the use of two consultant surgeons was associated with a significant increase in the number of cases subsequently performed in the same operating room during business hours [18].…”

Section: Discussionmentioning

confidence: 99%

Dual Surgeon Operating in Reverse Geometry Total Shoulder Replacement: The Learning Curve and Its Effects on Complication Rates

Parwaiz¹,

Whitham²,

Flintoftburt³

et al. 2022

Cureus

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We analyse the impact of implementing dual surgeon operating for reverse geometry total shoulder replacement (RGTSR) as part of the "Getting It Right First Time" (GIRFT) recommendations in our shoulder and elbow unit, and the learning curve associated with it. MethodsWe performed a retrospective cohort study comparing operative time and complication rates in patients who underwent RGTSR performed by a single consultant surgeon versus two consultant surgeons over a six-year period in a single centre, in addition to an analysing the learning curve over the same period. ResultsA total of 74 RGTSRs were performed over a six-year period: 35 patients had a single surgeon perform their procedure and 39 had dual surgeon operating. Observed complication rates for RGTSR nearly halved following the introduction of dual surgeon operating (22.9% vs 12.8%, p=0.36). The complication rate for the first 37 cases was 9/37 (24.4%) versus 4/37 (10.8%, p=0.22) for the next 37 cases. ConclusionThe implementation of dual surgeon operating may lead to reduced operative complications, provide cost savings to the hospital and produced several other non-tangible benefits to the surgeons and the department. An observed reduction in complication rates demonstrates the learning curve associated with this procedure.

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Section: Discussionmentioning

confidence: 99%

Dual Surgeon Operating in Reverse Geometry Total Shoulder Replacement: The Learning Curve and Its Effects on Complication Rates

Parwaiz¹,

Whitham²,

Flintoftburt³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…Cosurgery, known to be beneficial for this population, was used similarly in both groups, so its effect could not be measured. 37 Possibly the use of a co-surgeon may be of greater benefit at lower volume centers, especially those lacking a fellowship-level trainee. There may be unaccounted variables contributing to outcomes in this complex population.…”

Section: Discussionmentioning

confidence: 99%

“…The patient population is heterogeneous, so comparisons between groups and with previously published studies are at best, challenging. Co-surgery, known to be beneficial for this population, was used similarly in both groups, so its effect could not be measured 37. Possibly the use of a co-surgeon may be of greater benefit at lower volume centers, especially those lacking a fellowship-level trainee.…”

Section: Discussionmentioning

confidence: 99%

Does Routine Subspecialty Consultation Before High-Risk Pediatric Spine Surgery Decrease the Incidence of Complications?

Visser

Lehman

Armstrong

2022

Journal of Pediatric Orthopaedics

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Background: Children with neuromuscular disorders and syndromic scoliosis who require operative treatment for scoliosis are at increased risk for postoperative complications. Complications may include surgical site infection and pulmonary system problems including respiratory failure, gastrointestinal system disorders, and others. The purpose of our study was to determine the effect of a standardized perioperative pathway specifically designed for management of high-risk pediatric patients undergoing surgery for scoliosis. Methods: The High-Risk Protocol (HRP) at our institution is a multidisciplinary process with subspecialty consultations before scoliosis surgery. This was a retrospective chart and radiographic review at a single institution. Inclusion criteria were high-risk subjects, age 8 to 18 years old, who underwent surgery between January, 2009 and April, 2009 with a minimum 2-year follow-up. Diagnoses included neuromuscular scoliosis or Syndromic scoliosis.Results: Seventy one subjects were analyzed. The mean age was 13 ( ± 2 SD) years. Follow-up was 63 ( ± 24 SD) months. The study group consisted of 35 subjects who had fully completed the HRP and the control group consisted of 36 subjects who did not. Nine of the 35 (26%) subjects in the HRP had surgery delayed while interventions were performed. Compared with controls, the study group had larger preoperative and postoperative curve magnitudes: 90 versus 73 degrees (P = 0.002) and 35 versus 22 degrees (P = 0.001). Pulmonary disease was more common in the HRP, 60 versus 31% (P = 0.013). The overall incidence of complications in the study group was 29% (10 of 35 subjects) and for controls 28% (10 of 36). There were no differences between groups for types of complications or Clavien-Dindo grades.Three subjects in the study group and 1 in the controls developed surgical site infection. Eleven subjects required unplanned reoperations during the study period. Conclusions: The findings of our study suggest a structured pathway requiring routine evaluations by pediatric subspecialists may not reduce complications for all high-risk pediatric spine patients. Selective use of consultants may be more appropriate.

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With a Little Help from My Friends: Tips for Coding Common Pediatric Orthopaedic Procedures with Co‐Surgeons and Assistant Surgeons

Neal,

Muchow,

Louer

et al. 2024

Journal of the Pediatric Orthopaedic Society of North America

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The value-added benefit of utilizing two attending surgeons for patients with scoliosis secondary to cerebral palsy

Cited by 5 publications

References 17 publications

Dual Surgeon Operating in Reverse Geometry Total Shoulder Replacement: The Learning Curve and Its Effects on Complication Rates

Dual Surgeon Operating in Reverse Geometry Total Shoulder Replacement: The Learning Curve and Its Effects on Complication Rates

Does Routine Subspecialty Consultation Before High-Risk Pediatric Spine Surgery Decrease the Incidence of Complications?

With a Little Help from My Friends: Tips for Coding Common Pediatric Orthopaedic Procedures with Co‐Surgeons and Assistant Surgeons

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