Asian Spine J.  2011 Dec;5(4):208-212. 10.4184/asj.2011.5.4.208.

Variations in Practice Patterns among Neurosurgeons and Orthopaedic Surgeons in the Management of Spinal Disorders

Affiliations
  • 1Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. manzary2k@yahoo.com
  • 2Liaquat National Hospital, Karachi, Pakistan.
  • 3Department of Epidemiology and Biostatistics, Aga Khan Univerisity Hospital, Karachi, Pakistan.
  • 4Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.

Abstract

STUDY DESIGN: This is a case series. PURPOSE: We wanted to identify variations in the practice patterns among neurosurgeons and orthopedic surgeons for the management of spinal disorders. OVERVIEW OF LITERATURE: Spinal disorders are common in the clinical practice of both neurosurgeons and orthopedic surgeons. It has been observed that despite the availability of various guidelines, there is lack of consensus among surgeons about the management of various disorders.
METHODS
A questionnaire was distributed, either directly or via e-mail, to the both the neurosurgeons and orthopedic surgeons who worked at 5 tertiary care centers within a single region of Korea. The surgeons were working either in private practice or in academic institutions. The details of the questionnaire included demographic details and the specialty (orthopedic/neurosurgeon). The surgeons were classified according to the level of experience as up to 5 years, 6-10 years and > 10 years. Questions were asked about the approach to lumbar discectomy (fragmentectomy or aggressive disc removal), using steroids for treating discitis, the fusion preference for spondylolisthesis, the role of an orthosis after fusion, the preferred surgical approach for spinal stenosis, the operative approach for spinal trauma (early within 72 hours or late > 72 hours) and the role of surgery in complete spinal cord injury. The data was analyzed using SPSS ver 16. p-values < 0.05 were considered to be significant.
RESULTS
Of the 30 surgeons who completed the questionnaire, 20 were neurosurgeons and 10 were orthopedic surgeons. Statistically significant differences were observed for the management of spinal stenosis, spondylolisthesis, using an orthosis after fusion, the type of lumbar discectomy and the value of surgical intervention after complete spinal cord injury.
CONCLUSIONS
Our results suggest that there continues to exist a statistically significant lack of consensus among neurosurgeons and orthopedic spine surgeons when considering using an orthosis after fusion, the type of discectomy and the value of intervention after complete spinal injury.

Keyword

Orthopedic surgeons; Neurosurgeons; Spinal trauma; Spinal stenosis; Complete cord injury

MeSH Terms

Consensus
Discitis
Diskectomy
Electronic Mail
Korea
Orthopedics
Orthotic Devices
Private Practice
Spinal Cord
Spinal Cord Injuries
Spinal Injuries
Spinal Stenosis
Spine
Spondylolisthesis
Steroids
Tertiary Care Centers
Surveys and Questionnaires
Steroids
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