Pediatric Spine Foundation

Title: The Effect of Surgeon Experience on Outcomes Following Growth Friendly Instrumentation for Early Onset Scoliosis

Authors: Michael Heffernan, Manaf Younis, Michael Glotzbecker, Sumeet Garg, Claudia Leonardi, Selina Poon, Jaysson Brooks, Peter Sturm, Paul Sponseller, Michael Vitale, John Emans, Pediatric Spine Study Group (PSSG), Benjamin Roye

Journal: J Pediatr Orthop

Date: February 01, 2022

Excerpt: This study represents the first multicenter assessment of surgeon experience on outcomes in EOS. Overall, surgeon experience did not significantly influence unplanned return to the operating room, complication rates, estimated blood loss during surgery, or surgical time associated with growth friendly initial surgery in this cohort of EOS patients.

Keywords: early onset scoliosis, surgeon experience, growth friendly instrumentation

Summary:

Purpose

The purpose of this study was to determine if surgeon experience would limit complications and improve results of growth friendly instrumentation (GFI) in early onset scoliosis (EOS).

Results

  • A total of 960 patients were studied. Diagnosis, sex, where the devices were attached on the spine or rib, and EOSQ-24 scores were all similar between groups (P> 0.05). Surgeons were divided into two groups, early career surgeons (ECS) had 10 years or less of experience and advanced career surgeons (ACS) had more than 10 years of experience.
  • Unplanned returns to the operating room (35.8% vs. 32.7%), infection (17.0% vs. 15.6%), operating room time (235 vs. 231 min), and estimated blood loss (151 vs. 155 mL) were similar between ECS and ACS groups.
  • The frequency of having at least 1 complication or issue was somewhat high, but similar among groups (60.7% vs. 62.6%).
  • EOSQ-24 sections scores were similar between groups at 2-year follow-up (P>0.05). ECS had higher surgical time compared with ACS in severe curves > 90 degrees (270 vs. 229 min).

Discussion Points

  • Researchers thought that patients treated by ECS would have greater rates of unplanned returns to the operating room (UPROR), estimated blood loss (EBL), and surgical time; however, this study found that the experience level of the surgeon was not noteworthy for any of these.
  • Surgeon experience did not affect UPROR, complication rates, EBL, or surgical time associated with GFI. The children's and parents' reported experiences were also similar between the groups. This means that newer surgeons were just as successful as more experienced surgeons in conducting growth-friendly surgeries for EOS.