Surgeon Experience Affects Complication Rates After Spinal SurgeryPatients who undergoing surgery for spinal stenosis face a higher risk of complication if the surgeon performs less than four such procedures each year, according to a study published in Neurosurgery.
Researchers analyzed outcomes in nearly 49,000 patients undergoing surgery for lumbar spinal stenosis. Rates of complications and in-hospital death were compared for surgeons and hospitals with different "volumes" of surgery for spinal stenosis from 2005 through 2008. The volume of spinal stenosis surgeries by each surgeon was categorized from "very low" (less than 15 operations over four years) to "very high" (more than 81 procedures in four years). Hospital volume ranged from less than 68 to more than 394. These categories were compared with the risk of complications and death, with adjustment for other factors.
Their analysis showed that complication rates ranged from 11.6 percent for patients operated on by surgeons with a very low volume of spinal stenosis surgeries to 8.6 percent for surgeons who performed a very high volume of procedures. On adjusted analysis, the risk of complication was 38 percent higher for surgeons in the very low volume category, compared to the very high volume category. However, the difference is significant only on comparison of the lowest- versus highest-volume surgeons: averaging less than four versus more than 20 procedures per year.
Hospital nor surgeon volume, however, did not affect risk of death. In addition, hospital volume did not significantly affect complication rate.
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