Orthopaedics and neurosurgery: Is there a difference in surgical outcomes following anterior cervical spinal fusion?

Gautham Prabhakar; Nicholas Kusnezov; John Dunn; Andrew Cleveland; Joshua Herzog

doi:10.1016/j.jor.2020.05.015

Orthopaedics and neurosurgery: Is there a difference in surgical outcomes following anterior cervical spinal fusion?

J Orthop. 2020 May 18:21:278-282. doi: 10.1016/j.jor.2020.05.015. eCollection 2020 Sep-Oct.

Authors

Gautham Prabhakar¹, Nicholas Kusnezov², John Dunn², Andrew Cleveland², Joshua Herzog²

Affiliations

¹ Department of Orthopaedic Surgery, UT Health San Antonio, San Antonio, TX, USA.
² Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, El Paso, TX, USA.

Abstract

Objective: The superiority of neurosurgical over orthopaedic spinal procedures is a point of contention. While there is the perception that neurosurgeons are more specifically trained to deal with spinal pathology, no study has directly compared outcomes of spinal surgeries performed by both groups.

Methods: We sought to evaluate the differences in length of surgery, hospital stay, complications, mortality, and readmission for anterior cervical decompression and fusion (ACDF) performed by neurosurgeons versus orthopaedic surgeons.

Results: 17,967 ACDF procedures were analyzed. Neurosurgeons performed 74.3% of the fusions with a trend towards longer operative times and significantly more patients that were discharged to extended care facilities. There was no significant difference in the length of stay, overall complications, mortality, readmission, or reoperation when comparing the two specialties.

Conclusion: Despite a significantly higher volume of ACDF performed by neurosurgeons, outcomes are comparable following orthopaedic and neurosurgical procedures.

Keywords: ACDF; Anterior cervical decompression and fusion; Surgical outcome.