Abstract
BACKGROUND CONTEXT Clinical pathways are standardized protocols for the management of patients with common conditions or those undergoing common surgical procedures. Similarly, an operative efficiency methodology for AIS pts. comprising of a specialised care team of surgeons performing consistent operative steps and constant per-operative team is utilized in one institution. PURPOSE A standardized operative methodology in AIS ensures safe and efficient surgical care and also facilitates training of new surgeons. STUDY DESIGN/SETTING Prospective study performed at a tertiary care institution. PATIENT SAMPLE A total of 66 surgically managed AIS patients. METHODS AIS cases operated by three surgeons including a senior surgeon (SS; > 40 years exp), an experienced Surgeon (ES; >10 years exp) and a spine-trained surgeon new to practice (NS), with 6 months experience prior to this report, from Mar 2016 to Jan 2017 were studied. All AIS cases comprised of a specialized care team of surgeons performing consistent operative steps and constant perioperative team (same scrubtechs, radio technician, neurophysiologist and circulators). All surgeries had nine distinct operative steps and timing of each step was adjusted per level. EBL was noted. An ANOVA test was first used to compare for operative times amongst the three surgeons p RESULTS A total of 25 patients operated by SS, 25 by ES and 16 by NS for a total of 66 patients were initially studied. No significant differences were noted in the mean operative times or level amongst the three surgeons. (SS −15.9 minutes; ES – 14.6 minutes; NS – 16.1 minutes ; P>.05) For the second part, 24 pts in each group, totaling 48 pts were studied. The mean fusion levels for both groups were 10. The mean (M1) group one operative time was 181 minutes & group two (M2) was 195 minutes p- 0.19. Significant difference was noted for pontes or level (M1 – 4 minutes, M2 – 5 minutes; P CONCLUSIONS A review of AIS cases performed by three surgeons with varying levels of experience found that a standardized operative pathway and a specialized care teams ensured safe and efficient surgical care. The operative times were also similar irrespective of the experience of the surgeon, thereby demonstrating faster training of new surgeons. Significance: Standardized institutional operative methodology enhances the operative efficiency for AIS pts. By performing consistent operative steps & utilizing the same perioperative team, consistently low operative times may be produced. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Published Version
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