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Comparison Of The Volume Of Scoliosis Surgery Between Spine And Pediatric Orthopaedic Fellowship-trained Surgeons In New York And California.

M. Vitale, B. Heyworth, D. Skaggs, D. Roye, C. Lipton, M. Vitale
Published 2005 · Medicine

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BACKGROUND Controversy exists regarding the optimal fellowship training experience for surgeons who perform scoliosis surgery in pediatric patients. While many studies have demonstrated that higher surgical volumes are associated with superior outcomes, the volume of scoliosis procedures performed by pediatric orthopaedic-trained surgeons as opposed to spine surgery-trained surgeons has not been reported. METHODS Validated, statewide hospital discharge databases from the states of New York and California were utilized to examine the volume of spinal fusion procedures performed for the treatment of scoliosis in patients who were eighteen years of age or less. Fellowship training of surgeons in New York who had performed more than fifty procedures from 1992 to 2001 (that is, more than five procedures per year) was determined, and the operative volumes of surgeons who had received pediatric orthopaedic as opposed to spine fellowship training were compared. Hospitals in California with either type of fellowship program were identified, and the operative volumes of hospitals and fellows with pediatric orthopaedic or spine fellowship training from 1995 to 1999 were compared. RESULTS Among the 228 surgeons in New York who had performed one or more spinal fusion procedures in patients eighteen years of age or less from 1992 to 2001, only 13% (thirty) had performed more than five procedures per year. However, these thirty surgeons accounted for 75% (3858) of all 5136 procedures in this age-group. Surgeons who had completed a pediatric orthopaedic fellowship had performed a mean of 14.5 procedures per physician per year, whereas those who had completed a spine fellowship had performed a mean of 10.5 procedures per physician per year. Surgeons who had not completed either type of fellowship had performed a mean of 14.4 procedures per physician per year. In California, the mean annual volume of scoliosis procedures from 1995 to 1999 was 59.0 procedures per year at hospitals with pediatric orthopaedic fellowship programs and 15.7 procedures per year at those with spine surgery programs. The mean number of procedures per fellow at hospitals with pediatric orthopaedic fellowship programs was 31.6 procedures per fellow per year, and the mean number at hospitals with spine surgery programs was 12.7 procedures per fellow per year. Over time, there was a significant increase in the number of procedures per year at hospitals with both types of fellowship programs, but the percentage increase was greater for hospitals with pediatric orthopaedic fellowship programs than for hospitals with spine surgery fellowship programs (45.2% compared with 13.5%). CONCLUSIONS These data indicate that, on the average, a large number of surgeons in New York performed five scoliosis procedures per year or fewer. Among higher-volume surgeons in New York, those with pediatric orthopaedic fellowship training performed more scoliosis procedures on children and adolescents than those with orthopaedic spine training did. In California, the volume of scoliosis procedures at hospitals with pediatric orthopaedic fellowship programs was nearly four times greater than that at hospitals with spine fellowship programs and the volume of procedures per fellow was more than two times greater, and this disparity is widening over time. These data are an important element in establishing what type of fellowship best prepares surgeons for scoliosis surgery.
This paper references
10.1227/01.NEU.0000309607.38079.11
Surgeon Volume and Operative Mortality in the United States.
R. Harbaugh (2004)
Certificate of Special Qualification
CT Price (2003)
10.1097/01.bpo.0000153880.05314.be
The Contribution of Hospital Volume, Payer Status, and Other Factors on the Surgical Outcomes of Scoliosis Patients: A Review of 3,606 Cases in the State of California
M. Vitale (2005)
10.1097/00132586-198012000-00060
Should operations be regionalized? The empirical relation between surgical volume and mortality.
H. Luft (1979)
Certificate of Special Qualification. Bulletin of the Pediatric Orthopaedic Society of North America
C T Price (2003)
10.1097/00007632-200207010-00025
Controversies in Spine: Should There be Subspecialty Certification in Spine Surgery?
A. Dwyer (2002)
10.1097/00007632-200009150-00004
Professional Competence and Subspecialty Certification: Scoliosis Research Society: Harrington Lecture, September 23, 1999, San Diego, California
R. Dewald (2000)
10.2106/00004623-200309000-00017
Provider Volume of Total Knee Arthroplasties and Patient Outcomes in the HCUP-Nationwide Inpatient Sample.
Sheleika L Hervey (2003)
10.1016/S1070-3241(16)30195-X
The California Hospital Outcomes Project: using administrative data to compare hospital performance.
P. Romano (1995)
10.1161/01.STR.29.11.2292
Relationship between provider volume and mortality for carotid endarterectomies in New York state.
E. Hannan (1998)
10.1378/chest.107.6.1673
Investigating the impact of age on outcome of mechanical ventilation using a population of 41,848 patients from a statewide database.
I. Cohen (1995)
SPARCS: the New York State health care data system.
Quan Jm (1980)
10.1016/S1062-1458(02)00837-1
Hospital volume and surgical mortality in the United States.
J. Birkmeyer (2002)
10.2106/00004623-200209000-00031
Association between hospital and surgeon procedure volume and outcomes of orthopaedic surgery: caveats for interpretation of data and policy applications.
D. Saroff (2002)
10.1001/ARCHINTE.163.4.461
Differential use of coronary revascularization and hospital mortality following acute myocardial infarction.
J. Barnhart (2003)
SPARCS: the New York State health care data system.
J. Quan (1980)
10.2106/00004623-199704000-00003
Relationship between the Volume of Total Hip Replacements Performed by Providers and the Rates of Postoperative Complications in the State of Washington*
H. Kreder (1997)
10.2106/00004623-200111000-00022
The association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States Medicare population: health policy implications.
A. Morris (2001)
Report of results from the OSHPD reabstracting project: an evaluation of the reliability of selected patient discharge
A Chen (1990)
Challenges of the Spine Specialists: North American Spine Society Presidential Address Minneapolis, Minnesota, October 1994
C. Lee (1995)
Report of results from the OSHPD reabstracting project: an evaluation of the reliability of selected patient discharge data
A Chen
10.1002/ART.10754
Association of hospital and surgeon volume of total hip replacement with functional status and satisfaction three years following surgery.
J. Katz (2003)
10.1016/0022-3468(93)90221-6
Efficacy of pediatric trauma care: results of a population-based study.
A. Cooper (1993)
10.4135/9781483392271.n276
International Classification of Diseases--9th revision.
P. Loy (1978)
The California report on coronary artery bypass graft surgery 1999 hospital data: Technical report
CL Damberg (2003)
10.1097/00003246-200201000-00015
Regional variation in child mortality at hospitals lacking a pediatric intensive care unit
R. Kanter (2002)
New York State Education Department. Online verification searches
Pacific Business Group on Health and the California Office of Statewide Health Planning and Development
C L Damberg (2003)
10.1097/00000658-199308000-00003
Open Cholecystectomy A Contemporary Analysis of 42,474 Patients
J. Roslyn (1993)
Challenges of the spine specialists
C Lee



This paper is referenced by
10.1007/s43390-020-00058-9
Surgeon volume affects short- and long-term surgical outcomes in idiopathic scoliosis.
Dean C. Perfetti (2020)
10.2106/JBJS.16.00697
Short-Term Outcomes Following Hip Fractures in Patients at Least 100 Years Old
Arthur Manoli (2017)
10.1007/s00586-019-06098-8
Advancing spinal fellowship training: an international multi-centre educational perspective
A. Kumaria (2019)
10.2106/JBJS.F.00442
What's new in pediatric orthopaedics.
M. Kocher (2006)
10.4172/2161-0533.1000211
The Rising Incidence of Operative Treatment of Mid-shaft Clavicle Fractures
Alan J. Micev (2016)
10.1007/s00586-014-3209-y
Experience of a fellowship in spinal surgery: a quantitative analysis
Wojciech Konczalik (2014)
10.2106/00004623-201102160-00023
The rising incidence of acromioplasty.
Marc C Schneider (2011)
10.1097/BRS.0000000000000729
The Association Between Insurance Status and Complications, Length of Stay, and Costs for Pediatric Idiopathic Scoliosis
Samuel K. Cho (2015)
10.2106/JBJS.I.01003
The rising incidence of acromioplasty.
Mark A Vitale (2010)
10.1016/j.jse.2015.05.038
Shoulder arthroplasty in New York State, 1991 to 2010: changing patterns of utilization.
Omar N Khatib (2015)
10.1016/j.jse.2013.12.034
The incidence of proximal humeral fractures in New York State from 1990 through 2010 with an emphasis on operative management in patients aged 65 years or older.
O. Khatib (2014)
Adolescent Idiopathic Scoliosis and Adverse Events: A Canadian Perspective
Henry Ahn (2012)
10.1177/0363546515622407
Epidemiology of Medial Ulnar Collateral Ligament Reconstruction
J. L. Hodgins (2016)
10.1097/BRS.0b013e31827ecb1c
Do Authors Report Surgical Expertise in Open Spine Surgery Related Randomized Controlled Trials? A Systematic Review on Quality of Reporting
J. van Oldenrijk (2013)
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