The use of two attending surgeons during posterior spinal fusion (PSF) for cerebral palsy (CP) patients has been shown to improve perioperative outcomes. This study aims to determine if the use of two surgeons is associated with an increase in the number of subsequent surgeries that can be performed in the same operating room (OR) during business hours.
Patients with scoliosis and CP treated with PSF with minimum 90-day follow-up were included. Patients were grouped based on whether one or two attending surgeons performed the case. The primary outcome was the number of surgeries that followed in the same OR before 5 PM. Secondary outcomes included operative time, estimated blood loss (EBL), length of stay, rate of surgical site infection, and rate of unplanned return to the operating room.
Thirty-six patients were included (10 with 1 surgeon and 26 with 2 surgeons). The two surgeon group had a significant increase in the average number of surgeries subsequently performed in the same OR during business hours (1.1 vs. 0.3, p = 0.01), as well as shorter mean operative time (159 vs. 307 min, p = 0.007) and EBL (554 vs. 840 cc, p = 0.01; 26 vs. 39%EBV, p = 0.03).
The use of two attending surgeons was associated with a significant increase in the number of cases subsequently performed in the same OR during business hours, and significant decreases in operative time and EBL. Hospitals should consider the patient care and potential system-level improvements when considering implementation of two surgeon teams for PSF in CP patients.
Level of evidence
Therapeutic Level III.
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The data that support the findings of this study are available from the corresponding author, TCM, upon reasonable request.
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There were no sources of support for this work.
Conflict of interest
Dr. Brooks is a paid consultant for DePuy, and is a paid presenter or speaker for Medtronic. For the remaining authors, none were declared.
This retrospective chart review study involving human participants was in accordance with 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board (IRB) of The University of Mississippi Medical Center approved this study.
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McDonald, T.C., Gnam, A.L., Brooks, J.T. et al. The value-added benefit of utilizing two attending surgeons for patients with scoliosis secondary to cerebral palsy. Spine Deform (2021). https://doi.org/10.1007/s43390-021-00301-x
- Neuromuscular scoliosis
- Two attending surgeons
- Dual attending surgeons
- Cerebral palsy