Columbia Orthopedics Faculty Publishes Multicenter Retrospective Study in Journal of Pediatric Orthopaedics

Providers from the pediatric orthopedics service at Columbia Orthopedics published a retrospective review in the Journal of Pediatric Orthopaedics. The article, “The Effect of Surgeon Experience on Outcomes Following Growth-Friendly Instrumentation for Early-Onset Scoliosis,” assessed the effect of surgeon experience on outcomes of growth-friendly instrumentation (GFI) in early-onset scoliosis (EOS).

Collaborators included Michael G. Vitale, MD, and Benjamin D. Roye, MD. The retrospective review examined the role surgeon experience may play in minimizing complications associated with treating EOS with GFI.

Background

Early-onset scoliosis (EOS) is a complex condition that presents significant clinical and technical challenges for treatment. Defined as a curvature of the spine in children that is greater than 10 degrees before age 10, EOS poses a risk for impaired lung function because the progressive spinal deformity can impede thoracic growth during a pivotal time for lung development. Striking the right balance between early intervention to minimize the deformity’s progression and giving the spine sufficient opportunity to grow is critical. Due in part to the difficulty in managing this balance, growth-friendly surgical techniques for EOS are associated with higher complication rates compared to other types of spinal deformities.

One potential factor in reducing the complication rate is surgeon experience. While a number of studies have explored the impact of surgeon experience on outcomes for other spinal deformities like neuromuscular scoliosis and adolescent idiopathic scoliosis, there have been no multicenter studies to examine the effect of surgeon experience on EOS.

Methods

The review examined data from a multicenter international pediatric spine database. A total of 960 eligible pediatric patients diagnosed with EOS and treated with GFI were divided into two groups based on surgeon experience: early career surgeons (ECSs) with 10 or fewer years of experience and advanced career surgeons (ACSs) with more than 10 years of experience. The primary outcome was an unplanned return to the operating room (UPROR), with secondary outcomes including estimated blood loss (EBL), infection rate, and hardware failure.

Results

Outcomes such as UPROR, complication rates, EBL, and surgical time were comparable between the ECS and ACS groups. The results indicate that surgeon experience did not significantly influence outcomes in GFI for EOS. ECSs were able to manage patients with EOS as well as surgeons with more experience.

View the full article here.