Surgeon specialty differences in single-level anterior cervical discectomy and fusion.

Abstract

Retrospective cohort study. To determine the impact of spine surgeon specialty on 30-day postoperative complication rates of single-level anterior cervical discectomy and fusions (ACDFs). ACDFs are performed by both neurological and orthopedic surgeons. Although previous studies have examined preoperative risk factors for postoperative complications in ACDFs, no studies have shown the impact of surgical specialty on these variables. All patients who underwent any single-level ACDF between 2006 and 2012 were selected from the American College of Surgeons National Surgical Quality Improvement Program database. Propensity-score matching was used to reduce confounding preoperative differences. Baseline demographics, comorbidities, and complications were compared between the 2 surgical specialties using univariate analyses. Multivariate logistic regression models were created to isolate independent effects of surgeon specialty on complications. A total of 1944 patients undergoing single-level ACDFs were included in our analysis. Orthopedic surgeons and neurosurgeons performed 19.9% and 80.1% of ACDFs, respectively. Patients who underwent surgery by neurosurgeons had a higher number of comorbidities. After propensity matching, however, not all preoperative variables vary significantly between the specialty cohorts. Multivariate analysis of the propensity-matched groups revealed that for single-level ACDFs, treating physician cohort (orthopedic surgeons vs. neurosurgeons) was not associated with higher odds for overall complications (OR, 1.708; 95% CI, 0.849-3.436; P = 0.133), surgical site complications (OR, 0.869; 95% CI, 0.233-3.247; P = 0.835), or medical complications (OR, 1.863; 95% CI, 0.805-4.311; P = 0.146). Spine surgeon specialty is not a risk factor for any reported postoperative complication in patients undergoing single-level ACDFs. 4.