European Spine Journal

, Volume 27, Issue 3, pp 530–542 | Cite as

The impact of surgeon volume on patient outcome in spine surgery: a systematic review

  • Azeem Tariq Malik
  • Usman Younis Panni
  • Muhammad Usman Mirza
  • Maryam Tetlay
  • Shahryar Noordin



Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of surgeries to higher volume centers and adoption of volume standards. With limited literature promoting the regionalization of spine surgeries, we undertook a systematic review to investigate the impact of surgeon volume on outcomes in patients undergoing spine surgery.


We performed a systematic review examining the association between surgeon volume and spine surgery outcomes. To be included in the review, the study population had to include patients undergoing a primary or revision spinal procedure. These included anterior cervical discectomy and fusion (ACDF), anterior/posterior cervical fusion, laminectomy/decompression, anterior/posterior lumbar decompression with fusion, discectomy, and spinal deformity surgery (spine arthrodesis).


Studies were variable in defining surgeon volume thresholds. Higher surgeon volume was associated with a significantly lower risk of postoperative complications, a lower length of stay (LOS), lower cost of hospital stay and a lower risk of readmissions and reoperations/revisions.


Findings suggest a trend towards better outcomes for higher volume surgeons; however, further study needs to be carried out to define objective volume thresholds for individual spine surgeries for surgeons to use as a marker of proficiency.


Surgeon volume Provider volume Spine surgery Spine 



No funding was required for this study.

Compliance with ethical standards

Conflict of interest

No conflict of interest was declared by the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Azeem Tariq Malik
    • 1
  • Usman Younis Panni
    • 2
  • Muhammad Usman Mirza
    • 3
  • Maryam Tetlay
    • 2
  • Shahryar Noordin
    • 2
  1. 1.Department of OrthopaedicsThe Ohio State University Wexner Medical CenterColumbusUSA
  2. 2.Section of Orthopaedic Surgery, Department of SurgeryAga Khan UniversityKarachiPakistan
  3. 3.Department of Internal MedicineMedStar Washington Hospital CenterWashington, DCUSA

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