Two Spine Surgeons Are Better Than One

A new study demonstrates that having two attending surgeons in the operating room (OR) during spinal surgeries can benefit patients in multiple ways.

Researchers at the University of California, San Francisco (UCSF; USA) conducted a study that reviewed 80 patients who underwent pedicle subtraction osteotomy (PSO, a surgery that realigns the spine in cases of very severe deformities). Of these, 42 patients underwent the procedure with a single surgeon, versus 36 patients who had the same procedure under the care of two attending surgeons. The researchers analyzed estimated blood loss, length of surgery, length of stay, radiographic analysis, rate of return to the operating room within 30 days, and medical and neurological complications.

The results showed that the mean estimated blood loss for single versus two surgeons was 5,278 versus 2,003 mL, respectively, and average surgical time for single versus two surgeons was 7.6 versus 5.0 hours. A total of 45% of single-surgeon patients, compared with 25% of two-surgeon patients experienced at least one major complication within 30 days. In the single-surgeon group, 19% had unplanned surgery within 30 days, versus 8% in the two-surgeon group. Two-surgeon patients also enjoyed shorter hospital stays. The study was published in the January 2013 issue of Spine Deformity.

“We found very dramatic results," said lead author neurosurgeon Christopher Ames, MD. “The data suggests having two attending doctors is better and safer. If you had a drug or device that would result in this kind of improvement in treatment, of course you would give those to your patients.”

The idea to have multiple attending surgeons perform complicated surgeries is not new to medicine; many complicated procedures that fall under other specialties, such as cardiac surgery, are performed in this way, but most spinal surgeries in the United States are performed by teams led by a single attending surgeon.

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