280. Two attending surgeons improve outcomes of anterior cervical discectomy and fusion

Abstract

BACKGROUND CONTEXT Degenerative disease of the cervical spine is frequently encountered by spine surgeons, especially as the elderly population increases. Anterior cervical discectomy and fusion (ACDF) is one of the most common procedures performed to address this pathology, but it is not without complications. The involvement of a 2-attending surgeon team has been shown to have improved perioperative outcomes in complex spine procedures, such as deformity correction, in terms of reduced surgical time and blood loss. Reduction of these parameters are associated with improved patient outcomes. This matched cohort study sought to analyze the effect of using two attending surgeons in single level ACDF procedures. PURPOSE To analyze the effect of a 2-attending surgeon team on the outcomes of patients undergoing single-level ACDF procedures. STUDY DESIGN/SETTING Retrospective matched cohort study PATIENT SAMPLE A total of 42 matched patients who underwent single level ACDF with a minimum of 2-year follow-up. OUTCOME MEASURES (1) Anesthesia time, (2) surgical time, (3) blood loss, (4) postoperative complication rate, (5) fusion rate METHODS A retrospective matched cohort study of patients undergoing 1-level ACDF for degenerative cervical spondylosis, with minimum 2-year follow-up. Patients were subdivided into 2 cohorts: (A) cases performed by one attending surgeon assisted by resident, fellow, physician assistant or other medical staff, and (B) cases performed by an attending surgeon with another attending surgeon as first-assist. Patients were matched by age, sex, BMI, ASA and CCI. Perioperative data including anesthesia, surgical time, blood loss, postoperative complications and rate of fusion were compared. Standard binomial and categorical comparative analysis were performed. A p-value RESULTS A total of 42 patients were included (21 in each group). There were 22 males and 20 females, with a mean age of 47.7 years and mean follow-up of 43.4 months. There were no differences in any demographic variable between the two groups, indicating successful matching. Cohort B had decreased anesthesia time (114.9 vs 157.1 minutes, p CONCLUSIONS A 2-attending surgeon team significantly reduces anesthesia time, surgical time and blood loss, in 1-level ACDF procedures, without an increase in complications, or decrease in fusion rates. This further highlights the importance and benefits of having a second experienced attending surgeon present in these cases. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.