Clinician-to-Clinician Update Clinician-to-Clinician Update

Two-Surgeon Team Approach Leads to Improved Spinal Surgery Outcomes

November 2015 - Neurosurgery

Spinal reconstruction surgeries are technically demanding and come with a significant risk of intraoperative, perioperative, and postoperative complications. Over the past several years, research indicates that procedures conducted by 2 surgeons working together result in patient outcomes superior to those led by a single surgeon working alone.1,2 This is particularly the case in spinal surgery when the dual-surgeon team is made up of an orthopaedic surgeon and neurosurgeon.

Coupling the orthopaedic surgeon’s expertise in bone and fusion techniques with the neurosurgeon’s expertise in microsurgery on delicate nerve tissue can be particularly effective. In one study of 1,561 patients who underwent spinal surgery with this team approach, patients were 4 to 6 times less likely to experience a surgical site infection than were patients operated on by an orthopaedic surgeon or neurosurgeon alone.1 This particular team approach may also result in reduced time in surgery and fewer major complications. In a study comparing spinal surgery outcomes, average surgical time was 7.6 hours for the 42 patients operated on by a single surgeon but only 5.0 hours for the 36 patients who underwent procedures led by a neurosurgeon-orthopaedic surgeon duo.2

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— University of Minnesota Health neurosurgeon Matthew Hunt meets with a patient. M Health neurosurgeons regularly pursue a team-based approach in providing care.

The mean estimated blood loss was 5,278 mL for those operated on by a single surgeon but only 2,003 mL for those operated on by a surgeon team. A reported 45% of the single-surgeon patients experienced at least 1 major complication within 30 days, compared to only 25% of the dual-surgeon patients.2

Surgeons at the University of Minnesota Health Neurosurgery Clinic regularly coordinate with their colleagues and fellow surgeons at University of Minnesota Medical School’s Department of Orthopaedic Surgery and pursue a team approach to complex spinal surgery cases. A multidisciplinary model informs all phases of treatment, from the initial evaluation and surgical plan to postsurgical follow-up care, and ensures the best possible outcomes for patients. The team is proud to be at the leading-edge of research and practice aimed at optimizing outcomes for our spinal surgery patients.

References

1. Blam OG, Vaccaro AR, Vanichkachorn JS, et al. Risk factors for surgical site infection in the patient with spinal injury. Spine (Phila Pa 1976). 2003;28:1475-1480.

2. Ames CP, Barry JJ, Keshavarzi S, et al. Perioperative outcomes and complications of pedicle subtraction osteotomy in cases with single versus two attending surgeons. Spine Deformity. 2013;1:51-58.

When to Refer

The University of Minnesota Health neurosurgery team takes pride in delivering a multidisciplinary, team-based approach to the treatment of both simple and complex diseases. Our providers specialize in the management of all diseases addressed through neurosurgery, including:

  • Brain and spinal cord tumors
  • Brain aneurysms and AVMs
  • Moyamoya disease
  • Carotid stenosis
  • Complex spinal disease
  • Parkinson’s disease (surgical interventions for)
  • Pediatric neurological disease
  • Epilepsy (surgeries for)
  • Peripheral nerve disease

Patients with urgent medical or surgical needs are given priority in the appointment system. Appointments for nonurgent problems are scheduled several days to several weeks in advance. To refer a patient to the University of Minnesota Health Neurosurgery Clinic, please call 612-624-6666.

Collaborative Care

We are committed to working closely with you to ensure the best possible care for your patient. The decision to admit a patient for neurosurgery is always made in concert with the referring provider. Once the patient is transferred to our care, we communicate the ongoing management plan and the patient’s status to you, the referring provider, within 48 hours. Upon the patient’s discharge, we arrange a consultation call with the neurosurgery team and any collaborating specialists (e.g., orthopaedic surgeons) so that you have all the information you need to continue follow-up care with your patient.

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