Comparison Between Resident and Attending Surgeons as Assistants on Adolescent Idiopathic Scoliosis Surgery: No Differences in Outcomes, Complications Rate, or Pedicle Screw Placement Accuracy.
Journal
Clinical spine surgery
ISSN: 2380-0194
Titre abrégé: Clin Spine Surg
Pays: United States
ID NLM: 101675083
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
received:
27
11
2023
accepted:
28
06
2024
medline:
1
8
2024
pubmed:
1
8
2024
entrez:
1
8
2024
Statut:
aheadofprint
Résumé
Retrospective cohort study. The aim of the present study was to determine if the level of training of the first assistant (resident or attending surgeon) has an influence on the radiographic outcome of AIS surgery and on the accuracy rate of the pedicle screws placement. Adolescent idiopathic scoliosis (AIS) surgery is a challenging procedure that requires a dedicated team of skilled professionals. Therefore, understanding the learning curve is of outstanding importance to guarantee the best outcomes and the highest safety to the patients. A retrospective analysis of patients who underwent surgery for AIS with a minimum follow-up of 2 years was conducted. All patients were operated by an experienced spine surgeon, assisted by and attending surgeon (group A) or a senior resident (group B). Radiographic outcomes were assessed. Through postoperative CT scan, accuracy of pedicle screw placement was measured (using Gertzbein-Robbins classification). Groups were then statistically compared. A total of 120 patients were included (mean age 15.3±3.39 y, major curve Cobb 60.7±11.9 degrees). No difference was found between groups in terms of preoperative characteristics and postoperative radiographic (correction rate, thoracic kyphosis, screw density) outcomes or complications. Operative time and estimated blood loss were significantly higher in Group B (P=0.045 and P=0.024, respectively). Of the 2746 pedicle screws inserted (1319 group A and 1427 group B), 2452 had a perfect intrapedicular trajectory (absolute accuracy of 89.29%) and 2697 had a breach <2 mm (relative accuracy of 97.56%). No difference was found among groups in terms of absolute or relative accuracy (P=0.06 and P=0.23, respectively). AIS cases assisted by senior residents have longer operative time and higher blood loss, but this does not negatively affect the overall radiographic outcome and does not place the patient at increased risk of complications. III.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective cohort study.
OBJECTIVE
OBJECTIVE
The aim of the present study was to determine if the level of training of the first assistant (resident or attending surgeon) has an influence on the radiographic outcome of AIS surgery and on the accuracy rate of the pedicle screws placement.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Adolescent idiopathic scoliosis (AIS) surgery is a challenging procedure that requires a dedicated team of skilled professionals. Therefore, understanding the learning curve is of outstanding importance to guarantee the best outcomes and the highest safety to the patients.
METHODS
METHODS
A retrospective analysis of patients who underwent surgery for AIS with a minimum follow-up of 2 years was conducted. All patients were operated by an experienced spine surgeon, assisted by and attending surgeon (group A) or a senior resident (group B). Radiographic outcomes were assessed. Through postoperative CT scan, accuracy of pedicle screw placement was measured (using Gertzbein-Robbins classification). Groups were then statistically compared.
RESULTS
RESULTS
A total of 120 patients were included (mean age 15.3±3.39 y, major curve Cobb 60.7±11.9 degrees). No difference was found between groups in terms of preoperative characteristics and postoperative radiographic (correction rate, thoracic kyphosis, screw density) outcomes or complications. Operative time and estimated blood loss were significantly higher in Group B (P=0.045 and P=0.024, respectively). Of the 2746 pedicle screws inserted (1319 group A and 1427 group B), 2452 had a perfect intrapedicular trajectory (absolute accuracy of 89.29%) and 2697 had a breach <2 mm (relative accuracy of 97.56%). No difference was found among groups in terms of absolute or relative accuracy (P=0.06 and P=0.23, respectively).
CONCLUSIONS
CONCLUSIONS
AIS cases assisted by senior residents have longer operative time and higher blood loss, but this does not negatively affect the overall radiographic outcome and does not place the patient at increased risk of complications.
LEVEL OF EVIDENCE
METHODS
III.
Identifiants
pubmed: 39087678
doi: 10.1097/BSD.0000000000001670
pii: 01933606-990000000-00343
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
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