Does transitioning to a dual surgeon approach improve outcomes for posterior spinal fusion of adolescent idiopathic scoliosis and neuromuscular scoliosis?

Study design: Retrospective, chart review.

Purpose: Improvements in operative time, blood loss, and length of stay (LOS) when using a dual surgeon approach for the treatment of scoliosis have been suggested in the literature; however, the external validity of these findings has been debated. In this study, we examined the impact of transitioning from a single surgeon to a dual surgeon approach in the treatment of adolescent idiopathic scoliosis (AIS) and neuromuscular scoliosis (NMS) across non-contemporary periods at a single institution.

Methods: Through a retrospective chart review we identified 208 adolescent patients who underwent spinal fusion for the treatment of AIS or NMS between November 2015 and January 2022. The 73 cases meeting inclusion criteria were analyzed for operative time, blood loss, pre-and post-operative Cobb angles, and hospital length of stay.

Results: The dual surgeon AIS group was found to have a shorter hospital (3.6 vs. 5.2 days, p < 0.001) and ICU length of stay (0.3 vs. 3.7 days, p < 0.001), greater Cobb angle correction (35.6 vs. 23.3 degrees, p < 0.001), and lower transfusion requirement compared to the single surgeon AIS group (0.1 vs. 0.7 units, p = 0.003). Total operative time and estimated blood loss (EBL) were not significantly different. The dual surgeon NMS group only showed shorter ICU length of stay (2.9 vs. 9.1 days, p = 0.043).

Conclusions: Utilizing a dual surgeon approach for AIS patients could improve hospital and ICU length of stay, blood transfusion requirements, and Cobb angle correction without an increase in operative time.

Level of evidence: Level III, retrospective, comparative study.