Abstract
Background: Disorders of the hip and lumbar spine can create similar patterns of pain and dysfunction. It is unknown whether all surgeons, regardless of orthopedic or neurosurgery training, investigate and diagnose concurrent hip and spine pathology at the same rate. Methods: Data were retrieved from Taiwan’s National Health Insurance Research Database (NHIRD). Enrolled patients were stratified into hip and spine surgery at the same admission (Both), hip surgery before spine surgery (HS), or spine surgery before hip surgery (SH). The SH group was further subdivided based on whether spine surgery was performed by an orthopedic surgeon (OS) or neurosurgeon (NS), and differences in preoperative radiographic examinations and diagnoses were collected and analyzed. Results: In total, 1824 patients received lumbar spine surgery within 1 year before or after hip replacement surgery. Of these, 103 patients had spine and hip surgery in the same admission (Both), 1290 patients had spine surgery before hip surgery (SH), and 431 patients had hip surgery before spine surgery (HS). In the SH group, patients were categorized into spine surgery by orthopedic surgeons (OS) (n = 679) or neurosurgeons (NS) (n = 522). In the SH group, orthopedic surgeons investigated hip pathology with X-rays more often (52.6% vs. 38.1%, p < 0.001) and diagnosed more cases of hip disease (43.6% vs. 28.9%, p < 0.001) than neurosurgeons. Conclusions: Of patients in Taiwan’s NHIRD who had concurrent surgical degenerative hip and lumbar spine disorders who had spine surgery before hip surgery, orthopedic surgeons obtained hip images and made hip-related diagnoses more frequently than did neurosurgeons.
Highlights
Osteoarthritis (OA) is the most common musculoskeletal disease of the elderly and the most common cause of musculoskeletal-related disabilities worldwide
Among the remaining 1824 patients, 103 were categorized into the “Both” group, in which hip surgery and spine surgery were performed during the same admission; 1290 were categorized into the spine surgery before hip surgery (SH) group; and 431 had hip surgery performed before spine surgery, the (HS) group (Figure 1)
In this study of patients from Taiwan’s National Health Insurance Research Database (NHIRD) with hip-spine syndrome who had hip arthroplasty within 1 year of spine surgery, significantly more patients were assessed using hip X-rays and were diagnosed with hip pathology before surgery if their spine surgery was performed by an orthopedic surgeon
Summary
Osteoarthritis (OA) is the most common musculoskeletal disease of the elderly and the most common cause of musculoskeletal-related disabilities worldwide. Disorders of the hip and lumbar spine can create similar patterns of pain and dysfunction. It is unknown whether all surgeons, regardless of orthopedic or neurosurgery training, investigate and diagnose concurrent hip and spine pathology at the same rate. In the SH group, orthopedic surgeons investigated hip pathology with X-rays more often (52.6% vs 38.1%, p < 0.001) and diagnosed more cases of hip disease (43.6% vs 28.9%, p < 0.001) than neurosurgeons. Conclusions: Of patients in Taiwan’s NHIRD who had concurrent surgical degenerative hip and lumbar spine disorders who had spine surgery before hip surgery, orthopedic surgeons obtained hip images and made hip-related diagnoses more frequently than did neurosurgeons
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