Single- versus dual-surgeon outcomes in adult and pediatric spinal deformity patients: systematic review and meta-analysis.

PURPOSE: The current body of literature has examined both pediatric and adult patients in concert with respect to single- versus dual-surgeon treatment of spinal deformity; however, to our knowledge, pediatric and adult outcomes have not yet been reported independently. We hypothesize that the favorable outcomes seen in pediatric spine deformity with a dual-surgeon approach may also extend to adult spinal deformity patients.

METHODS

Databases were searched for studies involving surgeries around spinal deformities and the use of dual or single surgeons. For both dual- and single-surgeon group, details on rates of complications, operating room times, lengths of stay, blood loss, rates of transfusion, and reoperation rates were recorded. Categorical variables were reported in pooled odds ratio (OR) and continuous variables were reported in standardized mean difference (SMD). Alpha value of less than 0.05 was considered significant.

RESULTS

In adults, the dual-surgeon approach was associated with decreased risk of complications (OR = 0.31, 95% CI, 0.21-0.46; p < 0.01). In pediatrics, the dual-surgeon approach was associated with a decreased length of stay (SMD = -0.93 days, 95% CI: -1.25 - -0.61; p < 0.01) and operating time (SMD = -82.20 min, 95% CI: -114.28 - -51.32; p < 0.01).

CONCLUSION

The results of this study demonstrated statistically significant decrease in length of stay and operative duration with a dual-surgeon team in pediatric patients. In adults, a dual-surgeon team had correlated with a significant decreased rate of complications. There exists a lack of sufficient adult data to determine differences in operative duration, length of stay, and blood loss. Further investigation may utilize larger datasets to better understand the impacts of the dual-surgeon approach for both adult and pediatric populations.