Successful surgical resection of a rare case of a giant sacral chordoma: a multidisciplinary feat

Single-Surgeon Versus Dual-Surgeon Strategy in Spinal Tumor Surgery: A Single Institution Experience

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

The objective of this study is to compare the outcomes of spinal tumor surgery between dual-surgeon and single-surgeon approach.

SUMMARY OF BACKGROUND DATA

Perioperative adverse outcomes may be improved with 2 attending surgeons in spinal deformity cases. It is unclear if this advantage may be seen in spinal oncology operations.

METHODS

A retrospective chart review identified 24 patients who underwent spinal tumor surgery by two attending surgeons between January 1, 2016, and April 30, 2020 at a single tertiary care institution. 1:1 matching was then performed to identify 24 patients who underwent spinal tumor operations of similar complexity by a single attending surgeon. Postoperative outcomes were collected.

RESULTS

Cases in the dual-surgeon group had significantly lower total operative time (601 vs. 683 minutes), reduced estimated blood loss (956 vs. 1780 ml), and were less likely to have an intraoperative blood transfusion (41.7% vs. 75.0%). The incidence of cerebrospinal fluid leak and wound infection did not significantly differ between groups, nor were there differences in total length of hospital stay, discharge disposition, 6-month emergency room visit, readmission, and reoperation rates.

CONCLUSION

Dual-surgeon strategy in spinal tumors surgery may lead to decreased operative time and estimated blood loss. These benefits may have clinical and cost implications, but should be weighed against the impact of resident and fellow training.

LEVEL OF EVIDENCE

Level III.