Two Surgeon Approach for Complex Spine Surgery: Rationale, Outcome, Expectations, and the Case for Payment Reform. Issue 9 (1st May 2019)

• Record Type: Journal Article
• Authors: Bauer, Jennifer M.; Yanamadala, Vijay; Shah, Suken A.; Sethi, Rajiv K.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 27:Issue 9(2019)
• Publication Date: 2019-05-01
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-17-00717
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : There is an increased trend in complex spine deformity cases toward a two attending surgeon approach, but the practice has not become widely accepted by payers. Multiple studies have shown that spine surgery complications increase with the duration of case, estimated blood loss, and use of transfusions, as well as in certain high-risk populations or those requiring three-column osteotomies. Dual-surgeon cases have been shown to decrease estimated blood loss, transfusion rate, surgical times, and therefore complication rates. Although this practice comes at an uncertain price to medical training and short-term costs, the patient's quality of care should be prioritized by institutions and payers to include dual-surgeon coverage for these high-risk cases. Because we enter an era where the value of spine care and demonstrating cost-effectiveness is essential, dual surgeon attending approaches can enhance these tenets.