Back-to-Back Surgeries in AIS Patients Can be Performed Safely Without Compromising Radiographic or Perioperative Outcomes: A 10-year Review

Vishal Sarwahi, Jesse Galina, Stephen Wendolowski, Maximillian Ganz, Sayyida Hasan, Chhavi Katyal, Marina Moguilevitch, Jon Paul Dimauro, Yungtai Lo, Terry D. Amaral

Research output: Contribution to journalArticle

Abstract

Study Design.A retrospective chart review of prospectively collected data.Objective.The aim of this study was to determine whether back-to-back scoliosis surgeries can be performed safely without compromising outcomes and the reproducibility of the practice between institutions.Summary of Background Data.During the summer, spinal surgeons will often book multiple cases in one day. The complexity and demands of spinal fusion surgery call into question the safety. Change of operating room staff including anesthesiologists, nurses, and neurologists may introduce new risks.Methods.From 2009 to 2018, index AIS surgeries were included. In Groups 1, 2, and 3, surgeries were performed by a single surgeon. In Group 4, they were performed by other institutional surgeons. Group 1: first surgery of the day, Group 2: second surgery of the day, Group 3: only surgery of the day, Group 4: only surgery of the day by different institutional surgeon. Additional analysis was done to determine reproducibility after a surgeon was moved from Institution 1 to Institution 2.Results.Five hundred sixty-seven AIS patients were analyzed. Group 1 patients had similar radiographic outcomes compared with Group 2 (P>0.05). Surgical time was similar (P=0.51), but significantly more levels fused (P=0.01). Compared with Group 3, Group 2 had a smaller preoperative Cobb (P=0.02), shorter surgeries (P<0.001), and length of stay (P=0.04) but similar complication rate (P=1). Compared with Group 4, Group 2 had smaller preoperative Cobb (P<0.001), shorter surgery, and lower complication rate (P=0.03). When determining reproducibility, institution 2 patients had significantly less blood loss, shorter surgeries, and shorter lengths of stay (P<0.05).Conclusion.Although long and involved, back-to-back AIS surgeries do not compromise radiographic or perioperative outcomes. Changes in operating team do not appear to impact safety, efficiency, or outcomes. This study also found that the practice is reproducible between institutions.Level of Evidence: 3.

Original languageEnglish (US)
Pages (from-to)26-31
Number of pages6
JournalSpine
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

antineoplaston A10
Ambulatory Surgical Procedures
Length of Stay
Safety
Spinal Fusion
Scoliosis
Operating Rooms
Operative Time
Nurses
Surgeons

Keywords

  • adolescent idiopathic scoliosis
  • perioperative outcomes
  • posterior spinal fusion
  • surgery
  • surgical team
  • two surgeries

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Back-to-Back Surgeries in AIS Patients Can be Performed Safely Without Compromising Radiographic or Perioperative Outcomes : A 10-year Review. / Sarwahi, Vishal; Galina, Jesse; Wendolowski, Stephen; Ganz, Maximillian; Hasan, Sayyida; Katyal, Chhavi; Moguilevitch, Marina; Dimauro, Jon Paul; Lo, Yungtai; Amaral, Terry D.

In: Spine, Vol. 45, No. 1, 01.01.2020, p. 26-31.

Research output: Contribution to journalArticle

Sarwahi, V, Galina, J, Wendolowski, S, Ganz, M, Hasan, S, Katyal, C, Moguilevitch, M, Dimauro, JP, Lo, Y & Amaral, TD 2020, 'Back-to-Back Surgeries in AIS Patients Can be Performed Safely Without Compromising Radiographic or Perioperative Outcomes: A 10-year Review', Spine, vol. 45, no. 1, pp. 26-31. https://doi.org/10.1097/BRS.0000000000003172
Sarwahi, Vishal ; Galina, Jesse ; Wendolowski, Stephen ; Ganz, Maximillian ; Hasan, Sayyida ; Katyal, Chhavi ; Moguilevitch, Marina ; Dimauro, Jon Paul ; Lo, Yungtai ; Amaral, Terry D. / Back-to-Back Surgeries in AIS Patients Can be Performed Safely Without Compromising Radiographic or Perioperative Outcomes : A 10-year Review. In: Spine. 2020 ; Vol. 45, No. 1. pp. 26-31.
@article{f1a497d4bd9c469aa86a9e2d5400fae6,
title = "Back-to-Back Surgeries in AIS Patients Can be Performed Safely Without Compromising Radiographic or Perioperative Outcomes: A 10-year Review",
abstract = "Study Design.A retrospective chart review of prospectively collected data.Objective.The aim of this study was to determine whether back-to-back scoliosis surgeries can be performed safely without compromising outcomes and the reproducibility of the practice between institutions.Summary of Background Data.During the summer, spinal surgeons will often book multiple cases in one day. The complexity and demands of spinal fusion surgery call into question the safety. Change of operating room staff including anesthesiologists, nurses, and neurologists may introduce new risks.Methods.From 2009 to 2018, index AIS surgeries were included. In Groups 1, 2, and 3, surgeries were performed by a single surgeon. In Group 4, they were performed by other institutional surgeons. Group 1: first surgery of the day, Group 2: second surgery of the day, Group 3: only surgery of the day, Group 4: only surgery of the day by different institutional surgeon. Additional analysis was done to determine reproducibility after a surgeon was moved from Institution 1 to Institution 2.Results.Five hundred sixty-seven AIS patients were analyzed. Group 1 patients had similar radiographic outcomes compared with Group 2 (P>0.05). Surgical time was similar (P=0.51), but significantly more levels fused (P=0.01). Compared with Group 3, Group 2 had a smaller preoperative Cobb (P=0.02), shorter surgeries (P<0.001), and length of stay (P=0.04) but similar complication rate (P=1). Compared with Group 4, Group 2 had smaller preoperative Cobb (P<0.001), shorter surgery, and lower complication rate (P=0.03). When determining reproducibility, institution 2 patients had significantly less blood loss, shorter surgeries, and shorter lengths of stay (P<0.05).Conclusion.Although long and involved, back-to-back AIS surgeries do not compromise radiographic or perioperative outcomes. Changes in operating team do not appear to impact safety, efficiency, or outcomes. This study also found that the practice is reproducible between institutions.Level of Evidence: 3.",
keywords = "adolescent idiopathic scoliosis, perioperative outcomes, posterior spinal fusion, surgery, surgical team, two surgeries",
author = "Vishal Sarwahi and Jesse Galina and Stephen Wendolowski and Maximillian Ganz and Sayyida Hasan and Chhavi Katyal and Marina Moguilevitch and Dimauro, {Jon Paul} and Yungtai Lo and Amaral, {Terry D.}",
year = "2020",
month = "1",
day = "1",
doi = "10.1097/BRS.0000000000003172",
language = "English (US)",
volume = "45",
pages = "26--31",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Back-to-Back Surgeries in AIS Patients Can be Performed Safely Without Compromising Radiographic or Perioperative Outcomes

T2 - A 10-year Review

AU - Sarwahi, Vishal

AU - Galina, Jesse

AU - Wendolowski, Stephen

AU - Ganz, Maximillian

AU - Hasan, Sayyida

AU - Katyal, Chhavi

AU - Moguilevitch, Marina

AU - Dimauro, Jon Paul

AU - Lo, Yungtai

AU - Amaral, Terry D.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Study Design.A retrospective chart review of prospectively collected data.Objective.The aim of this study was to determine whether back-to-back scoliosis surgeries can be performed safely without compromising outcomes and the reproducibility of the practice between institutions.Summary of Background Data.During the summer, spinal surgeons will often book multiple cases in one day. The complexity and demands of spinal fusion surgery call into question the safety. Change of operating room staff including anesthesiologists, nurses, and neurologists may introduce new risks.Methods.From 2009 to 2018, index AIS surgeries were included. In Groups 1, 2, and 3, surgeries were performed by a single surgeon. In Group 4, they were performed by other institutional surgeons. Group 1: first surgery of the day, Group 2: second surgery of the day, Group 3: only surgery of the day, Group 4: only surgery of the day by different institutional surgeon. Additional analysis was done to determine reproducibility after a surgeon was moved from Institution 1 to Institution 2.Results.Five hundred sixty-seven AIS patients were analyzed. Group 1 patients had similar radiographic outcomes compared with Group 2 (P>0.05). Surgical time was similar (P=0.51), but significantly more levels fused (P=0.01). Compared with Group 3, Group 2 had a smaller preoperative Cobb (P=0.02), shorter surgeries (P<0.001), and length of stay (P=0.04) but similar complication rate (P=1). Compared with Group 4, Group 2 had smaller preoperative Cobb (P<0.001), shorter surgery, and lower complication rate (P=0.03). When determining reproducibility, institution 2 patients had significantly less blood loss, shorter surgeries, and shorter lengths of stay (P<0.05).Conclusion.Although long and involved, back-to-back AIS surgeries do not compromise radiographic or perioperative outcomes. Changes in operating team do not appear to impact safety, efficiency, or outcomes. This study also found that the practice is reproducible between institutions.Level of Evidence: 3.

AB - Study Design.A retrospective chart review of prospectively collected data.Objective.The aim of this study was to determine whether back-to-back scoliosis surgeries can be performed safely without compromising outcomes and the reproducibility of the practice between institutions.Summary of Background Data.During the summer, spinal surgeons will often book multiple cases in one day. The complexity and demands of spinal fusion surgery call into question the safety. Change of operating room staff including anesthesiologists, nurses, and neurologists may introduce new risks.Methods.From 2009 to 2018, index AIS surgeries were included. In Groups 1, 2, and 3, surgeries were performed by a single surgeon. In Group 4, they were performed by other institutional surgeons. Group 1: first surgery of the day, Group 2: second surgery of the day, Group 3: only surgery of the day, Group 4: only surgery of the day by different institutional surgeon. Additional analysis was done to determine reproducibility after a surgeon was moved from Institution 1 to Institution 2.Results.Five hundred sixty-seven AIS patients were analyzed. Group 1 patients had similar radiographic outcomes compared with Group 2 (P>0.05). Surgical time was similar (P=0.51), but significantly more levels fused (P=0.01). Compared with Group 3, Group 2 had a smaller preoperative Cobb (P=0.02), shorter surgeries (P<0.001), and length of stay (P=0.04) but similar complication rate (P=1). Compared with Group 4, Group 2 had smaller preoperative Cobb (P<0.001), shorter surgery, and lower complication rate (P=0.03). When determining reproducibility, institution 2 patients had significantly less blood loss, shorter surgeries, and shorter lengths of stay (P<0.05).Conclusion.Although long and involved, back-to-back AIS surgeries do not compromise radiographic or perioperative outcomes. Changes in operating team do not appear to impact safety, efficiency, or outcomes. This study also found that the practice is reproducible between institutions.Level of Evidence: 3.

KW - adolescent idiopathic scoliosis

KW - perioperative outcomes

KW - posterior spinal fusion

KW - surgery

KW - surgical team

KW - two surgeries

UR - http://www.scopus.com/inward/record.url?scp=85076876664&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076876664&partnerID=8YFLogxK

U2 - 10.1097/BRS.0000000000003172

DO - 10.1097/BRS.0000000000003172

M3 - Article

C2 - 31361724

AN - SCOPUS:85076876664

VL - 45

SP - 26

EP - 31

JO - Spine

JF - Spine

SN - 0362-2436

IS - 1

ER -