Association Between Surgeon Experience and Complication Rates in Adult Scoliosis Surgery A Review of 5117 Cases From the Scoliosis Research Society Database 2004-2007

作者：Skovrlj Branko; Cho Samuel K^*; Caridi John M; Bridwell Keith H; Lenke Lawrence G; Kim Yongjung J

来源：Spine, 2015, 40(15): 1200-1205.

DOI：10.1097/BRS.0000000000000993

• adult
• deformity
• spine surgery
• complications
• morbidity
• mortality
• surgeon experience

Study Design. Retrospective review of a multicenter database.
Objective. To evaluate whether surgeon experience is associated with complication rates in adult spinal deformity (ASD) surgery.
Summary of Background Data. Multiple patient-and surgery-related factors have been shown to increase the risk of complications in ASD. No study exists evaluating surgeon experience as an associated factor with complications in ASD.
Methods. The Scoliosis Research Society Morbidity and Mortality database was queried for patients older than 18 years who underwent ASD from 2004 to 2007. Patient demographics, surgical characteristics, complications, and surgeon membership status were analyzed. Two-tailed t test and chi(2) tests were performed, with P value of less than 0.05 considered significant.
Results. A total of 5117 patients underwent ASD surgery. The average patient age was 51.8 years. Patients operated by candidate members were older than those operated by active members (53.1 vs. 51.4, P = 0.003). Active members performed 3836 (75%) cases whereas candidate members performed 1281 cases. There were 1110 (21.7%) revisions. A total of 681 (13.3%) complications were recorded, 498 (13.0%) for active and 183 (14.3%) for candidate members, respectively (P = 0.24). Mortality rate was 0.29%. Spinal cord complications accounted for 0.68% of all cases. Active members had 21 (0.55%) spinal cord complications, whereas candidates had 14 (1.1%) (P = 0.049). There were a total of 174 (3.4%) surgical site infections (SSI). Active members had 82 (2.1%) deep SSI, whereas candidate members had 36 (2.8%) deep SSI (P = 0.164). Active members had 33 (0.9%) superficial SSI whereas candidate members had 23 (1.8%) superficial SSI (P = 0.008).
Conclusion. There was a statistically significant, 2-fold increase in the rate of spinal cord complications and superficial SSI among candidate compared with active members. Overall complication rates were similar between candidate and active members.

• 出版日期2015-8-1