Establishing objective volume-outcome measures for anterior and posterior cervical spine fusion.

摘要: Abstract Objectives There is a growing literature on the relationship between provider volume and patient outcomes, specifically within joint arthroplasty lumbar spine surgery. Such benchmarks have yet to be established for many other spinal procedures, including cervical fusion. We sought determine whether outcomes-based measures both surgeons hospitals can fusion procedures. Patients methods This was retrospective review of data in Florida Statewide Inpatient Dataset (SID; 2011–14). identified SID who underwent either anterior or posterior were along with operative where procedures performed. Socio-demographic data, as well medical surgical characteristics obtained, development complications readmissions up 90 days following hospital discharge. Surgeon plotted separately against number an adjusted spline analysis. Multivariable logistic regression analysis subsequently performed assess effect surgeon post-operative readmissions. Results 8960 patients 57,108 fusions (total = 66,068) inclusion The low-volume found increased (OR 1.83; 95% CI 1.65, 2.02) likelihood 1.45; 1.24, 1.69) Low-volume demonstrated readmission, irrespective 1.37; 1.29, 1.47) 1.31; 1.16, 1.48) approach. No clinically meaningful differences detected high- hospitals. Conclusions study demonstrates objective volume-outcome perform fusions. Our results immediate applicability clinical practice may used benchmark procedural volume. Findings respect speak need healthcare regionalization this specific context.