The particular complex procedure considered in the study is called a pedicle subtraction osteotomy, a surgery that realigns the spine in cases of very severe deformities, many of which arise from alignment complications of prior surgery and severe degenerative spinal arthritis.
Adult spinal deformity is becoming more common as the baby boomer population ages, as is the demand for the corrective surgery, said Ames. "Older adults are demanding higher levels of function as they get older," he said.
UCSF has top-ranking programs in both neurological and orthopedic surgery and is a referral center for particularly complex, high-risk spinal surgeries. Surgeons at UCSF currently perform over 75 such operations every year many on older patients who may have osteoporosis, heart problems and other age-related issues that make the surgeries even more complicated.
After they began collaborating five years ago, Ames and Deviren became convinced that working together had a positive impact on their patients, but they wanted to quantify how much. They compared 42 patients who underwent the surgery at UCSF with a single surgeon, versus 36 patients who had the same procedures under the care of two attending surgeons.
They found that in addition to spending less time in the operating room, patients in the group with two surgeons suffered half as much blood loss on average during surgery and were much less likely to have major complications or unplanned additional surgeries within a month of their original operation.
For Ames and Deviren, these tangible benefits are fundamentally no different from those that patients might reap by using a new drug or some other clinical intervention. The bottom line, Ames said, is that the data suggests having two attending doctors is better and safer.
"If you had a drug or device that would result in this kind of improvement in treatment , of course you would give those
|Contact: Jason Socrates Bardi|
University of California - San Francisco