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Setting for single position surgery: survey from expert spinal surgeons

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Abstract

Purpose

To describe a comprehensive setting of the different alternatives for performing a single position fusion surgery based on the opinion of leading surgeons in the field.

Methods

Between April and May of 2021, a specifically designed two round survey was distributed by mail to a group of leaders in the field of Single Position Surgery (SPS). The questionnaire included a variety of domains which were focused on highlighting tips and recommendations regarding improving the efficiency of the performance of SPS. This includes operation room setting, positioning, use of technology, approach, retractors specific details, intraoperative neuromonitoring and tips for inserting percutaneous pedicle screws in the lateral position. It asked questions focused on Lateral Single Position Surgery (LSPS), Lateral ALIF (LA) and Prone Lateral Surgery (PLS). Strong agreement was defined as an agreement of more than 80% of surgeons for each specific question. The number of surgeries performed in SPS by each surgeon was used as an indirect element to aid in exhibiting the expertise of the surgeons being surveyed.

Results

Twenty-four surgeons completed both rounds of the questionnaire. Moderate or strong agreement was found for more than 50% of the items. A definition for Single Position Surgery and a step-by-step recommendation workflow was built to create a better understanding of surgeons who are starting the learning curve in this technique.

Conclusion

A recommendation of the setting for performing single position fusion surgery procedure (LSPS, LA and PLS) was developed based on a survey of leaders in the field.

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Availability of data and material

Data associated with the manuscript may be made available upon request.

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Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Elite Spine Health and Wellness Center, Fort Lauderdale, FL, USA

    Alfredo Guiroy & Jahangir Asghar

  2. Barrow Neurological Institute/St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA

    Bernardo de Andrada-Pereira, Jay D. Turner & Juan Uribe

  3. UCI Medical Center, University of California, Irvine, USA

    Gastón Camino-Willhuber

  4. IRRCS Istituto Ortopedico Galeazzi, Via R.Galeazzi, 4, Milan, Italy

    Pedro Berjano & Claudio Lamartina

  5. Melbourne Orthopedic Group, Melbourne, Australia

    Aaron J. Buckland

  6. Spine and Scoliosis Research Associate Australia, Melbourne, Australia

    Aaron J. Buckland

  7. Spine Research Center, NYU Langone, Department of Orthopedics, New York, NY, USA

    Aaron J. Buckland

  8. Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, Canada

    Martin Gagliardi

  9. Georgia Spine and Neurosurgery Center, Atlanta, GA, USA

    Kaveh Khajavi

  10. Atlantic Brain and Spine, Wilmington, NC, USA

    J. Alex Thomas

  11. Columna Instituto, Vila da Serra/Biocor, Belo Horizonte, Brazil

    Cristiano Menezes

  12. The Spine Hospital at New York Presbyterian/Columbia University Medical Center, New York, NY, USA

    Ronald Lehman Jr

Authors
  1. Alfredo Guiroy
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  2. Bernardo de Andrada-Pereira
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  4. Pedro Berjano
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  8. Kaveh Khajavi
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  9. Jay D. Turner
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  10. J. Alex Thomas
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  11. Cristiano Menezes
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  12. Ronald Lehman Jr
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  13. Juan Uribe
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  14. Jahangir Asghar
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Corresponding author

Correspondence to Pedro Berjano.

Ethics declarations

Conflicts of interest

Alfredo Guiroy: No relevant financial or non-financial interests to disclose. Bernardo de Andrada-Pereira: No relevant financial or non-financial interests to disclose. Gastón Camino-Willhuber: No relevant financial or non-financial interests to disclose. Pedro Berjano: Nuvasive-Consultancy/Research support/ Royalties, Medacta-Consultancy, Alphatec Consultancy, K2M- Consultancy/ Research support, DePuy J&J- Research support. Claudio Lamartina: Nuvasive-Consultancy/Research support/ Royalties, Medacta-Consultancy, Alphatec Consultancy, K2M- Consultancy/ Research support, DePuy J&J- Research support. Aaron J. Buckland: Nuvasive-Consultancy, Medtronic-Advisory Board/Consultancy, Altus Spine-Royalties and Consulting, Integrity Spine-Consultancy, Medacta-Honoraria for educational events. Martin Gagliardi: No relevant financial or non-financial interests to disclose. Kaveh Khajavi: Nuvasive-Consultancy/Education/Product Development. Jay Turner: Nuvasive-Consultancy/Education/Research, SeaSpine-Consulting/Research/Royalties, ATEC-Consulting. J. Alex Thomas: Nuvasive-Consulting, royalties. TrackX-stockholder. Cristiano Menezes: Nuvasive-Consulting, research grants and Product development. Ronald Lehman: Medtronic-Consultancy and royalty fee, Department of Defense-research grant outside of the submitted work. Juan Uribe: Nuvasive-Consultancy, stock ownership, research grants, SI Bone-Consultancy, Viseon-Consultancy. Jahangir Asghar: Nuvasive-Consultancy/Education, Medtronic-Consultancy/ Education/ Product Development, Immertec-Education.

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Informed consent was not required for this survey study.

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Consent for publication was not required for this survey study.

Ethics approval

The questionnaires and methodology for this study were approved by the Institutional Review Board of MetroWest Medical Center (IRB #2021–008).

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Guiroy, A., de Andrada-Pereira, B., Camino-Willhuber, G. et al. Setting for single position surgery: survey from expert spinal surgeons. Eur Spine J 31, 2239–2247 (2022). https://doi.org/10.1007/s00586-022-07228-5

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  • DOI: https://doi.org/10.1007/s00586-022-07228-5

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