A scoping review of spine surgeries between specialties: comparing neurosurgeons versus orthopedic surgeon

Spine surgeries are both performed by neurosurgeons and orthopedic surgeons. However, there remains controversy whether surgeon specialty affects spine surgery outcomes and complications. The objective of this scoping review was to map the existing knowledge comparing the outcomes and complications of spine surgeries between neurosurgeons and orthopedic surgeons. Eligible studies are any English-written or -translated published journals written from year 2000 onwards that compared outcomes and/or complications of spine surgeries between neurosurgeons and orthopedic surgeons. Excluded papers are those which do not dichotomize or specify the surgeon specialty to either neurosurgeon or orthopedic surgeon. Medline database was used to systematically search for papers that compare the two specialties. Ten studies were selected which directly compared spine surgery outcomes of the two specialties, all of which are retrospective studies and most of it relied on the national database. Specific spine surgeries were varied between all studies. Overwhelmingly, these studies showed no significant differences between neurosurgeons and orthopedic surgeons in short term outcomes while there were some significant differences in complications. Based on this scoping study, surgeon specialty, whether neurosurgery or orthopedics, has no significant association in spine surgery outcomes. This may imply that despite the differences in training, patients may have good outcomes if treated by either specialty. However, questions remain whether the effect of further training after residency or fellowship, length of experience and number of cases of both surgeon specialties have a causal effect in outcomes of spine surgeries.

Exposición a radiación del cirujano de columna / Radiation exposure of the spine surgeon

Resumen: Introducción: en general, los cirujanos de columna buscan minimizar el daño a tejidos blandos empleando abordajes menos invasivos, lo que ocasiona que utilicen imágenes intraoperatorias de una manera mucho más habitual que el resto de las especialidades quirúrgicas; por lo tanto, están en mayor riesgo de exposición de radiación. Objetivo: el propósito del trabajo es analizar la cantidad de radiación a la cual está expuesto el cirujano de columna en diferentes escenarios. Material y métodos: estudio prospectivo con una fuente de datos descriptiva, longitudinal, no aleatorizada. Se llevó a cabo el estudio en el período del año 2015 al 2019; la protección radiológica consistió en chaleco plomado, protector de tiroides y lentes plomados; se usaron 10 dosímetros. Resultados: cuatro dosímetros fueron incluidos en el estudio, los otros seis fueron excluidos. Durante el estudio, un cirujano sufrió de cáncer de tiroides y otro de liposarcoma. En el grupo de protegidos se incluyeron dos cirujanos, en el grupo de protección aleatorizada se incluyó un cirujano y en el grupo sin protección se incluyó un cirujano. El dosímetro del grupo sin protección recibió mayor cantidad de radiación en todos los años, se realizó un análisis inferencial por año relacionado con el número de cirugías no encontrando correlación significativa, atribuimos este resultado a que no clasificamos el tipo de cirugía realizada por cada cirujano. Conclusión: el cirujano de columna debe de aplicar los métodos primarios de protección radiológica, ya que los cirujanos de columna sin equipo de protección reciben mayor cantidad de radiación en comparación con los protegidos.

Abstract: Introduction: in general, spine surgeons seek to minimize soft tissue damage by using less invasive approaches, which causes them to use intraoperative images much more frequently than other surgical specialties; therefore, they are at increased risk of radiation exposure. Objective: the aim of this work was to analyse the amount of radiation to which the spine surgeon is exposed in different scenarios. Material and methods: a prospective study with a descriptive, longitudinal non-randomized data source. We carried out this study in the period from 2015 to 2019, the radiologic protection consisted in lead apron, thyroid shield and leaded glasses, there were 10 badge dosimeters. Results: only 4 dosimeters were included in the study, the other six were excluded. During the study period one surgeon suffered thyroid cancer and other suffered of liposarcoma. In the protected group were two surgeons, in the group of aleatory exposition was one surgeon and in the unprotected group was one surgeon. In the study the dosimeter in the unprotected group received more amount of radiation in all the years, we did an inferential analysis per year related with the number of surgeries without significant correlation, we attribute this result because we didn't classified the type of surgery realized by each surgeon. Conclusion: we conclude that the spine surgeon must apply the primary methods of radiological protection and that the unprotected spine surgeon receives more amount of radiation in comparison of the protected ones.

Work-Related Musculoskeletal Disorders among Spine Surgeons / 대한정형외과학회잡지

PURPOSE: To investigate the prevalence and risk factors of musculoskeletal disorder (MSD) among spine surgeons. MATERIALS AND METHODS: A modified version of discomfort survey was sent via e-mail to surgeons that belong to the Korean Society of Spine Surgery. The survey questionnaires were composed of demographics, factors relating to spine surgery, and MSD. We investigated the common sites of occurrence of MSD and its risk factors. RESULTS: The survey was sent to a total of 420 subjects; of which, 80 subjects (19.0%) responded. About 78.8% of the respondents had MSD for the past year. The common sites of occurrence included the neck (52.5%), back (46.3%), and shoulder (18.8%). The prevalence of pain in the elbow joint/forearm was higher in the group performing a higher frequency of spine surgeries (p=0.033). Moreover, the prevalence of pain in the wrist/hand (p=0.008) and in the back (p=0.042) was higher in those with greater frequency of major surgeries (>10 case/year) as compared with those with lower frequency of major surgeries. CONCLUSION: As shown, about 78.8% of spine surgeons experienced MSD for the past one year. Its prevalence was higher as compared with the general population. Thus, more attention should be paid to the prevention of MSD among spine surgeons.