Neurosurgery compared to orthopedic spine consultation: A single level I trauma center experience

Shaina Sedighim; Brynn Sargent; Areg Grigorian; Christina Grabar; Anvesh R. Macherla; Michael Oh; Yu-Po Lee; John Scolaro; Jefferson Chen; Jeffry Nahmias

Brain and Spine (Jan 2024)

Neurosurgery compared to orthopedic spine consultation: A single level I trauma center experience

Shaina Sedighim,
Brynn Sargent,
Areg Grigorian,
Christina Grabar,
Anvesh R. Macherla,
Michael Oh,
Yu-Po Lee,
John Scolaro,
Jefferson Chen,
Jeffry Nahmias

Affiliations

Shaina Sedighim: Division of Trauma, Burns, And Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA
Brynn Sargent: Division of Trauma, Burns, And Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA
Areg Grigorian: Division of Trauma, Burns, And Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA
Christina Grabar: Division of Trauma, Burns, And Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA
Anvesh R. Macherla: Division of Trauma, Burns, And Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA
Michael Oh: Department of Neurosurgery, University of California, Irvine, Orange, CA, USA
Yu-Po Lee: Department of Orthopedic Surgery, University of California, Irvine, Orange, CA, USA
John Scolaro: Department of Orthopedic Surgery, University of California, Irvine, Orange, CA, USA
Jefferson Chen: Department of Neurosurgery, University of California, Irvine, Orange, CA, USA
Jeffry Nahmias: Division of Trauma, Burns, And Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA; Corresponding author. Building 26, 101 The City Dr S, Orange, CA, 92868, USA.

Journal volume & issue: Vol. 4
p. 102808

Abstract

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Introduction: Both Orthopedic Surgery (OS) and Neurosurgery (NS) perform spine surgery in the setting of trauma. However, it is unknown whether outcomes differ between these specialties. This study compares management and outcomes for vertebral fractures between NS and OS, hypothesizing similar operation rate, length of stay (LOS), and readmission. Research question: Do outcomes differ between NS and OS in the management of vertebral fractures following trauma? Methods: A retrospective single-center study was conducted on adult patients with cervical, thoracic, lumbar, and sacral fractures treated at a single trauma center, where no standardized pathway exists across NS and OS. Patients were compared for injury profile, diagnostic imaging, and operative techniques as well as LOS, mortality, and complications. Results: A total of 630 vertebral fracture patients (OS:350 (55.6%); NS:280 (44.4%)) were included. NS utilized magnetic resonance imaging (MRI) more commonly (36.4% vs. 22.6%, p 0.05). Post-operative complications, LOS, and readmission rates were similar between cohorts (p > 0.05). Discussion and conclusion: Despite similar injury profiles, NS had higher rates of MRI usage and operative interventions in the context of traumatic spine fractures. Despite differences in management, major clinical outcomes were similar between NS and OS. However, we do call for further standardization of evaluation and treatment of patients based on established algorithms from such as the AOSpine Thoracolumbar Spine Injury Classification System (ATLICS).

Published in Brain and Spine

ISSN: 2772-5294 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/brain-and-spine

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Abstract

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