The acute management of spinal fractures is traditionally split between neurosurgeons and orthopedic surgeons, and the specialties have varying approaches to management. This study investigates differences between neurosurgery and spinal orthopedic surgeons in managing spinal fractures at a single trauma center in the United Kingdom. A retrospective study at a single trauma center of patients identified using the Trauma Audit and Research Network or TARN. The doctors and researchers reviewed case notes and radiological investigations based on demographics, fracture classification, clinical management, and outcomes. Polytrauma cases and patients managed by non-neurosurgical or orthopedic specialties were excluded.
A total of 465 patients were included in this study. There were no significant differences between groups for age, gender, Charlson comorbidity score, or fracture distribution using the AO spine classification. Patients admitted and managed under orthopedic surgeons were more likely to undergo a surgical procedure when compared to those permitted under the neurosurgeons. The median overall length of stay was eight days. There was no significant difference between teams; however, the neurosurgical cohort was more likely to be admitted to an intensive care unit. This study is the first in the United Kingdom to compare neurosurgical and orthopedic teams to manage spinal fractures. It demonstrates that differences may exist both in operating rates and outcomes.
Ref: https://www.tandfonline.com/doi/full/10.1080/02688697.2020.1763256
