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Spine Operations by Orthopedic Surgeons

Anytime you have major surgery, your doctor has help. There are nurses, anesthetists, and surgical assistants. Other doctors are involved, too. In the case of spinal surgery, the extra doctor may be a general surgeon. A specialist in the heart and blood vessels called a vascular surgeon may be on hand.

Who does a better job? The orthopedic spine surgeon or the doctor who is assisted by another specialist? This is the focus of a study from a United States spine surgeon. Only one type of operation was reviewed: anterior spinal surgery. In these surgeries, the body is opened from the front. The reason for the surgery varied among the 450 patients enrolled. Some had spinal deformities. Others had fractures, tumors, infection, or disc disease.

The researchers compared complications due to the method used to open the body. Problems included amount of blood loss, length of surgery time, number of deaths, and number of blood vessels damaged. The researchers found a big decrease in problems among patients treated only by an orthopedic surgeon. Problems in the group operated on by an orthopedic surgeon along with another surgeon were much higher.

The authors conclude that orthopedic surgeons should be able to operate on the spine using an anterior approach without the assistance of another surgeon. In many places orthopedic surgeons aren't allowed to do this without special training. Some centers don't allow it even when the doctor is qualified.

This report supports the idea that training should be changed to include this method of spine surgery. The researchers think this training should be offered to any orthopedic surgeon who wants to get approval for these techniques.

References: Richard T. Holt, et al. The Efficacy of Anterior Spine Exposure by an Orthopedic Surgeon. In Journal of Spinal Disorders. October 2003. Vol. 16. No. 5. Pp. 477-486.

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