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Optimizing Patient Outcomes in Spinal Surgery: An Investigation Into Anesthesiologists’ Case Volume – Lumbar Fusion

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This article, published in Cureus, explores the potential associations between anesthesiologists’ case volume and patient postoperative outcomes in the early recovery period. The study focuses on patients undergoing anterior cervical discectomy and fusion (ACDF), lumbar decompression (LD), and lumbar fusion (LF) procedures from July 2019 to June 2023. The analysis categorizes anesthesiologists into low, medium, and high volumes of spine surgical cases. The results show no significant differences in ACDF patients based on anesthesiologist volume. However, for LD patients, there was a difference in patients with an American Society of Anesthesiologists (ASA) physical status classification of three or greater. For LF patients, there were differences in patients with low temperatures in the post-anesthesia care unit (PACU) and the percentage of patients with a 90-day emergency department return. The study concludes that while anesthesiologist volume has a minimal impact on postoperative outcomes, teamwork and specialized surgical teams are crucial in enhancing efficiency and patient care. Further research is needed to investigate other variables that may affect postoperative outcomes in spinal surgeries

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established day surgery unit in the world

Published article

Introduction Nearly one million patients in the United States undergo spine surgical procedures annually to seek relief from chronic back and neck pain. A multidisciplinary approach is key to ensuring the efficiency and safety of the surgical process, with the anesthesia team, nursing, surgeon, and healthcare facilities all playing a role. The purpose of this study is to capture potential associations between the anesthesiologists’ case volume and patient postoperative outcomes in the early…

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Cureus. 2023 Nov 28;15(11):e49559. doi: 10.7759/cureus.49559. eCollection 2023 Nov.ABSTRACTIntroduction Nearly one million patients in the United States undergo spine surgical procedures annually to seek relief from chronic back and neck pain. A multidisciplinary approach is key to ensuring the efficiency and safety of the surgical process, with the anesthesia team, nursing, surgeon, and healthcare facilities,

Cureus. 2023 Nov 28;15(11):e49559. doi: 10.7759/cureus.49559. eCollection 2023 Nov.

ABSTRACT

Introduction Nearly one million patients in the United States undergo spine surgical procedures annually to seek relief from chronic back and neck pain. A multidisciplinary approach is key to ensuring the efficiency and safety of the surgical process, with the anesthesia team, nursing, surgeon, and healthcare facilities all playing a role. The purpose of this study is to capture potential associations between the anesthesiologists’ case volume and patient postoperative outcomes in the early recovery period. Methods A retrospective review of anterior cervical discectomy and fusion (ACDF), lumbar decompression (LD), and lumbar fusion (LF) patients from July 2019 to June 2023 was performed. Anesthesiologists were categorized into low, medium, and high volumes of spine surgical cases. Univariate analysis was performed on patient demographics, intraoperative measures, post-anesthesia care unit (PACU) measures, and postoperative measures by anesthesiologist volume. Results This study included 545 ACDF, 815 LD, and 1,144 LF patients. There were no differences between groups in ACDF patients by anesthesiologist volume. When examining patients undergoing LD, there was a difference in patients with an American Society of Anesthesiologists (ASA) physical status classification of three or greater (low volume: 41.7% vs. medium volume: 53.7% vs. high volume: 45.0%; p=0.029). When examining patients undergoing LF, there were differences in patients with low temperatures in PACU (low volume: 2.8% vs. medium volume: 7.3% vs. high volume: 4.2%; p=0.044) and the percentage of patients with a 90-day emergency department return (low volume: 7.7% vs. medium volume: 11.9% vs. high volume: 7.0%; p=0.024). While this study found a minimal impact of anesthesiologist volume on postoperative outcomes, recent literature has emphasized the critical role of teamwork and specialized surgical teams to enhance efficiency and patient care. Further studies are warranted to identify other variables in anesthesia, nursing, and surgical team workflow that may impact postoperative outcomes in spinal surgeries.

PMID:38156156 | PMC:PMC10753864 | DOI:10.7759/cureus.49559

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Optimizing Patient Outcomes in Spinal Surgery: An Investigation Into Anesthesiologists’ Case Volume

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Cureus. 2023 Nov 28;15(11):e49559. doi: 10.7759/cureus.49559. eCollection 2023 Nov.ABSTRACTIntroduction Nearly one million patients in the United States undergo spine surgical procedures annually to seek relief from chronic back and neck pain. A multidisciplinary approach is key to ensuring the efficiency and safety of the surgical process, with the anesthesia team, nursing, surgeon, and healthcare facilities

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