Surgeon volume affects short- and long-term surgical outcomes in idiopathic scoliosis.

摘要: STUDY DESIGN Retrospective review of New York Statewide Planning and Research Cooperative System (SPARCS) Inpatient Database. OBJECTIVE To identify the differences in short- long-term complications, following long-segment pediatric spinal fusion idiopathic scoliosis surgery, between surgeons with low versus high annual surgical volume. Spinal deformity surgery is complex requires significant training repetition to master. Surgeon hospital volume have been shown correlate outcomes cervical lumbar spine surgery. However, there limited literature regarding impact surgeon on correction. METHODS This a retrospective SPARCS inpatient database from 2004 2013 patients who underwent Surgeons were stratified into (> 15 cases/year)- (≤ 15 cases/year)-volume cohorts by aggregating all cases completed over study period until 50% total captured above below an average case per-year threshold. threshold occurred at 15 cases/year. Short-term readmission medical/surgical complications collected. Multivariate logistic regression models assessed risk cohorts. RESULTS 3910 primary arthrodesis 223 surgeons. More high-volume operated academic teaching hospitals (p < 0.001), used combined AP approach fewer utilized rhBMP (p < 0.001). High-volume had shorter lengths stay Low-volume increased odds (OR 1.55, 95% CI 1.00-2.45). revision 5 10 years (5 years. OR 1.56, 1.05-2.31; 10 years. 1.59, 1.09-2.31). implant malfunction 1.81, 1.15-2.86). CONCLUSIONS decreased compared when performing scoliosis. experienced significantly greater as well during follow-up post-operatively. LEVEL OF EVIDENCE Level III.