Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures

Background: A significant procedural overlap exists between orthopedic and neurosurgeons with both subspecialties performing adult spinal fusion procedures. However, the prevalence of varying adult spinal fusion procedures performed by orthopedic surgeons, relative to neurosurgeons, is unknown. This...

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Main Authors: Frank A. Segreto, Oscar Krol, Samuel Gedailovich, Asher Ripp, George A. Beyer, David Kim, Daniel J. Alsoof, Hallie A. Tiburzi, Olivia Merola, Neil V. Shah, Peter G. Passias, Jad Bou Monsef, Alan H. Daniels, Carl B. Paulino, Bassel G. Diebo
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Craniovertebral Junction and Spine
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Online Access:https://journals.lww.com/10.4103/jcvjs.jcvjs_159_24
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author Frank A. Segreto
Oscar Krol
Samuel Gedailovich
Asher Ripp
George A. Beyer
David Kim
Daniel J. Alsoof
Hallie A. Tiburzi
Olivia Merola
Neil V. Shah
Peter G. Passias
Jad Bou Monsef
Alan H. Daniels
Carl B. Paulino
Bassel G. Diebo
author_facet Frank A. Segreto
Oscar Krol
Samuel Gedailovich
Asher Ripp
George A. Beyer
David Kim
Daniel J. Alsoof
Hallie A. Tiburzi
Olivia Merola
Neil V. Shah
Peter G. Passias
Jad Bou Monsef
Alan H. Daniels
Carl B. Paulino
Bassel G. Diebo
author_sort Frank A. Segreto
collection DOAJ
description Background: A significant procedural overlap exists between orthopedic and neurosurgeons with both subspecialties performing adult spinal fusion procedures. However, the prevalence of varying adult spinal fusion procedures performed by orthopedic surgeons, relative to neurosurgeons, is unknown. This study sought to compare the prevalence of spinal fusion procedures among orthopedic and neurosurgeons. Materials and Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for adult spinal fusion procedures from 2008 to 2016. Procedure prevalence, operative time, and hospital length of stay (LOS) were recorded and analyzed by surgical subspecialty. Spinal fusion cases investigated include all fusions, 2–3-level lumbar fusion, ≥4-level lumbar fusion, anterior cervical discectomy and fusion (ACDF), 3–6-level posterior cervical fusion, and ≥ 6-level posterior cervical fusion. Results: 67,775 spinal fusions were identified, of which 44,879 (66.2%) were performed by neurosurgeons and 22,896 (33.7%) were performed by orthopedic surgeons. Procedures that involved the lumbar spine were more likely to be performed by orthopedic surgeons while cervical fusions like ACDF were more likely to be performed by neurosurgeons. Orthopedic surgeons had significantly shorter operative times (124.0 vs. 134.0 min, P < 0.001) for 2–3-level lumbar fusions while having a similar patient LOS (4.3 vs. 4.2 days, P = 0.196). The remaining procedures saw no significant difference in operative time and patient LOS between orthopedic and neurosurgeons. Conclusions: Neurosurgeons performed nearly double the amount of spinal fusion cases compared to orthopedic surgeons, with an even greater disparity seen in ACDFs, while orthopedic surgeons performed significantly more fusions of the lumbar spine. Orthopedic surgeons had shorter operative times for 2–3-level lumbar fusions.
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spelling doaj-art-241eb193a17e4444a65183d10e4c223d2025-08-20T03:25:59ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852025-01-01161616510.4103/jcvjs.jcvjs_159_24Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion proceduresFrank A. SegretoOscar KrolSamuel GedailovichAsher RippGeorge A. BeyerDavid KimDaniel J. AlsoofHallie A. TiburziOlivia MerolaNeil V. ShahPeter G. PassiasJad Bou MonsefAlan H. DanielsCarl B. PaulinoBassel G. DieboBackground: A significant procedural overlap exists between orthopedic and neurosurgeons with both subspecialties performing adult spinal fusion procedures. However, the prevalence of varying adult spinal fusion procedures performed by orthopedic surgeons, relative to neurosurgeons, is unknown. This study sought to compare the prevalence of spinal fusion procedures among orthopedic and neurosurgeons. Materials and Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for adult spinal fusion procedures from 2008 to 2016. Procedure prevalence, operative time, and hospital length of stay (LOS) were recorded and analyzed by surgical subspecialty. Spinal fusion cases investigated include all fusions, 2–3-level lumbar fusion, ≥4-level lumbar fusion, anterior cervical discectomy and fusion (ACDF), 3–6-level posterior cervical fusion, and ≥ 6-level posterior cervical fusion. Results: 67,775 spinal fusions were identified, of which 44,879 (66.2%) were performed by neurosurgeons and 22,896 (33.7%) were performed by orthopedic surgeons. Procedures that involved the lumbar spine were more likely to be performed by orthopedic surgeons while cervical fusions like ACDF were more likely to be performed by neurosurgeons. Orthopedic surgeons had significantly shorter operative times (124.0 vs. 134.0 min, P < 0.001) for 2–3-level lumbar fusions while having a similar patient LOS (4.3 vs. 4.2 days, P = 0.196). The remaining procedures saw no significant difference in operative time and patient LOS between orthopedic and neurosurgeons. Conclusions: Neurosurgeons performed nearly double the amount of spinal fusion cases compared to orthopedic surgeons, with an even greater disparity seen in ACDFs, while orthopedic surgeons performed significantly more fusions of the lumbar spine. Orthopedic surgeons had shorter operative times for 2–3-level lumbar fusions.https://journals.lww.com/10.4103/jcvjs.jcvjs_159_24neurosurgeryorthopedic surgeryoutcomesspinal fusion
spellingShingle Frank A. Segreto
Oscar Krol
Samuel Gedailovich
Asher Ripp
George A. Beyer
David Kim
Daniel J. Alsoof
Hallie A. Tiburzi
Olivia Merola
Neil V. Shah
Peter G. Passias
Jad Bou Monsef
Alan H. Daniels
Carl B. Paulino
Bassel G. Diebo
Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures
Journal of Craniovertebral Junction and Spine
neurosurgery
orthopedic surgery
outcomes
spinal fusion
title Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures
title_full Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures
title_fullStr Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures
title_full_unstemmed Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures
title_short Orthopedic surgery versus neurosurgery: Prevalence and surgical detail assessment of adult spinal fusion procedures
title_sort orthopedic surgery versus neurosurgery prevalence and surgical detail assessment of adult spinal fusion procedures
topic neurosurgery
orthopedic surgery
outcomes
spinal fusion
url https://journals.lww.com/10.4103/jcvjs.jcvjs_159_24
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