A Multicenter Comparative Study of Neurosurgical and Orthopedic Spine Services for the Management of Spinal Conditions at Level I Trauma Centers.

BACKGROUND

Spinal conditions are commonly managed by both neurosurgeons and orthopedic spine surgeons, but differences in clinical approaches and outcomes remain underexplored.

OBJECTIVE

The objective of the study is to compare patient demographics, consultation patterns, surgical techniques, and early postoperative outcomes between neurosurgery and orthopedic spine services at Level I trauma centers.

METHODOLOGY: This retrospective multicenter study analyzed 690 patients who presented with spinal conditions and were treated either by neurosurgery (n = 355; 51.5%) or orthopedic (n = 335; 48.5%) spine services. Variables assessed included age, gender, injury type, spinal region involved, imaging utilization, management type, surgical techniques, operative duration, hospital stay, complications, ICU admissions, and discharge status. Statistical analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY, US). Chi-squared and independent t-tests compared categorical and continuous variables, respectively, with significance set at p < 0.05.

RESULTS

Mean patient age was comparable between groups (47.25 ± 16.4 years in neurosurgery vs. 45.80 ± 15.9 years in orthopedics, p = 0.231). Male patients comprised 238 (67.04%) in neurosurgery and 223 (66.57%) in orthopedics (p = 0.911). Traumatic injuries accounted for 203 (57.18%) neurosurgery and 188 (56.12%) orthopedic cases (p = 0.782). Lumbar spine involvement was higher in orthopedic patients with 151 (45.07%) vs. 132 (37.18%) in neurosurgery (p = 0.042). Operative management was performed in 195 (54.93%) neurosurgical and 181 (54.03%) orthopedic patients (p = 0.811). Neurosurgeons more frequently performed decompression with fusion (132, 67.69% vs. 101, 55.80%, p = 0.017) and used anterior or combined approaches (106, 54.36% vs. 70, 38.67%, p = 0.002), with longer mean operative times (152.6 ± 37.5 minutes vs. 138.9 ± 34.2 minutes, p = 0.003). Postoperative complications occurred in 41 (11.55%) neurosurgical and 36 (10.75%) orthopedic patients (p = 0.735). ICU admissions were similar between the two groups, with 54 patients (15.21%) in the neurosurgery group and 49 patients (14.63%) in the orthopedic group (p = 0.847). Likewise, 30-day readmission rates did not differ significantly, with 12 patients (3.38%) readmitted in the neurosurgery group compared to nine patients (2.69%) in the orthopedic group (p = 0.579).

CONCLUSION

Despite differences in surgical approaches, neurosurgery and orthopedic spine services demonstrated comparable consultation patterns and clinical outcomes, supporting multidisciplinary collaboration in trauma care.