Featured Research

from universities, journals, and other organizations

Two spine surgeons are three times safer than one

Date:
March 26, 2014
Source:
Group Health Research Institute
Summary:
A new team approach has improved safety -- reducing rates of major complications by two-thirds -- for complex spinal reconstructive surgery for spinal deformity in adult patients reviewed by a study. A new article gives a detailed description of the standardized protocol before, during, and after the surgery.

"We can shorten the operation when we have two surgeons in the operating room as equal partners: a neurosurgeon and an orthopedic surgeon with specialized spine training," said lead author Rajiv K. Sethi, MD.
Credit: Image courtesy of Group Health Research Institute

A new team approach has improved safety -- reducing rates of major complications by two thirds -- for complex spinal reconstructive surgery for spinal deformity in adult Group Health patients at Virginia Mason Hospital & Seattle Medical Center. An article in the March issue of Spine Deformity gives a detailed description of the standardized protocol before, during, and after the surgery, stressing the new approach's three main features:

Related Articles


  • Two spine surgeons in the operating room
  • A live preoperative screening conference
  • Monitoring bleeding during the operation

The research team reviewed 164 consecutive patients: 40 before and 124 after the new three-pronged approach was implemented. After implementation, patients were three times less likely to develop major complications. Improvements included significant reductions in rates of wound infection, deep vein thrombosis, pulmonary embolism, and urinary tract infections. Patients were also significantly less likely to have to return to the operating room within 90 days after the surgery.

"We can shorten the operation when we have two surgeons in the operating room as equal partners: a neurosurgeon and an orthopedic surgeon with specialized spine training," said lead author Rajiv K. Sethi, MD. He is an orthopedic spinal surgeon in the neurosurgery department at Group Health Physicians, the director of spinal deformity and complex reconstruction at Virginia Mason, and a clinical assistant professor of health services at the University of Washington (UW) School of Public Health.

"Reconstructive surgery for adults with spine deformities like scoliosis and kyphosis is being done increasingly often," Dr. Sethi said. "But this kind of surgery tends to be long and difficult, and it is among the most dangerous and complication-ridden of all operations. And often the outcomes and complications are unacceptable, including some patients losing more blood than they started with." That's why the new approach uses a standardized protocol to monitor and manage any bleeding during the operation.

The new approach also involves a feature that has never been described before: a live conference with clinicians from various disciplines. They are the operative surgeons, an internist, a physical medicine and rehabilitation physician, the nurses who coordinate a class for complex spine patients, and at least two members of the anesthesiology team dedicated to complex spine surgery. Together, they identify and treat health and medication issues that, undetected, might otherwise have derailed an operation at the last minute. Planning well in advance, they discuss -- and decide -- whether proposed surgery is appropriate for each patient.

"Our findings could help medical teams at Group Health and around the country reduce complications -- and likely cut costs too -- while improving performance and patient outcomes," Dr. Sethi said. "But all clinicians at Group Health and Virginia Mason are paid on salary. By contrast, at medical centers where doctors are paid on a fee-for-service basis, with more pay for doing more procedures, it might be harder to institute this kind of systems approach, because it entails up-front costs and commitment from leadership."


Story Source:

The above story is based on materials provided by Group Health Research Institute. Note: Materials may be edited for content and length.


Journal Reference:

  1. Rajiv K. Sethi et al. The Seattle Spine Team Approach to Adult Deformity Surgery: A Systems-Based Approach to Perioperative Care and Subsequent Reduction in Perioperative Complication Rates. Spine Deformity, March 2014 DOI: 10.1016/j.jspd.2013.12.002

Cite This Page:

Group Health Research Institute. "Two spine surgeons are three times safer than one." ScienceDaily. ScienceDaily, 26 March 2014. <www.sciencedaily.com/releases/2014/03/140326102729.htm>.
Group Health Research Institute. (2014, March 26). Two spine surgeons are three times safer than one. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2014/03/140326102729.htm
Group Health Research Institute. "Two spine surgeons are three times safer than one." ScienceDaily. www.sciencedaily.com/releases/2014/03/140326102729.htm (accessed March 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, March 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) — Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com
These Popular Antibiotics Can Cause Permanent Nerve Damage

These Popular Antibiotics Can Cause Permanent Nerve Damage

Newsy (Mar. 27, 2015) — A popular class of antibiotic can leave patients in severe pain and even result in permanent nerve damage. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins