Need for (Safe) Speed in the OR

A new retrospective cohort study on adult deformity surgery suggests that the amount of time surgeons spend in the operating room correlates with perioperative morbidity.

The research, “After Posterior Fusions for Adult Spinal Deformity, Operative Time is More Predictive of Perioperative Morbidity, Rather Than Surgical Invasiveness: A Need for Speed?” was published in the December 15, 2017 edition of Spine.

Co-author, Jonathan N. Grauer, M.D. told OTW, “Adult spinal deformity is a growing area of spine surgery practice and is receiving increased research interest. It is well known that complications are high after these difficult procedures and significant focus has been placed on reducing these complication risks. As many risk factors are patient related, and not modifiable by surgeons, surgical timing offers one possible factor in direct control by surgeons.”

“We used multivariable regression analysis using a large national dataset to analyze the independent relationships between both extent of surgical intervention and operative time. Previously these factors have been studied independently allowing for bias from possible confounding effects between the two different factors.”

The authors wrote, “A total of 1540 patients undergoing posterior spinal fusion for adult spinal deformity were identified. The overall rate of complications was 15.3%.”

Dr. Grauer commented to OTW, “Surgical timing, rather than extent of surgical intervention/morbidity, had the strongest relationship with postoperative complications. Surgical timing should be minimized, within safe limits, when performing adult spinal deformity surgery. Adult spinal deformity surgery should be performed by surgeons who can safely minimize operative time. The overall extent of surgical intervention should be reduced from what is indicated if surgery can be performed in an efficient manner.”