Multidisciplinary Evaluation Leads to the Decreased Utilization of Lumbar Spine Fusion
| العنوان: | Multidisciplinary Evaluation Leads to the Decreased Utilization of Lumbar Spine Fusion |
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| المؤلفون: | Vijay Yanamadala, Rajiv K. Sethi, Quinlan D. Buchlak, Farrokh Farrokhi, James R. Babington, Yourie Kim, Andrew S. Friedman, Robert S. Mecklenburg, Anna K. Wright, Jean-Christophe Leveque |
| المصدر: | Spine. 42:E1016-E1023 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | medicine.medical_specialty, Cost effectiveness, medicine.medical_treatment, Clinical Decision-Making, MEDLINE, Pilot Projects, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Multidisciplinary approach, medicine, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, Lumbar Vertebrae, business.industry, Evidence-based medicine, Spinal Fusion, Spinal fusion, Cohort, Physical therapy, Interdisciplinary Communication, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery |
| الوصف: | STUDY DESIGN Observational cohort pilot study. OBJECTIVE To determine the impact of a multidisciplinary conference on treatment decisions for lumbar degenerative spine disease. SUMMARY OF BACKGROUND DATA Multidisciplinary decision making improves outcomes in many disciplines. The lack of integrated systems for comprehensive care for spinal disorders has contributed to the inappropriate overutilization of spine surgery in the United States. METHODS We implemented a multidisciplinary conference involving physiatrists, anesthesiologists, pain specialists, neurosurgeons, orthopaedic spine surgeons, physical therapists, and nursing staff. Over 10 months, we presented patients being considered for spinal fusion or who had a complex history of prior spinal surgery. We compared the decision to proceed with surgery and the proposed surgical approach proposed by outside surgeons with the consensus of our multidisciplinary conference. We also assessed comprehensive demographics and comorbidities for the patients and examined outcomes for surgical patients. RESULTS A total of 137 consecutive patients were reviewed at our multidisciplinary conference during the 10-month period. Of these, 100 patients had been recommended for lumbar spine fusion by an outside surgeon. Consensus opinion of the multidisciplinary conference advocated for nonoperative management in 58 patients (58%) who had been previously recommended for spinal fusion at another institution (χ = 26.6; P |
| تدمد: | 1528-1159 0362-2436 |
| DOI: | 10.1097/brs.0000000000002065 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7858b7cf1eeec3cec2d285dc16830e3c https://doi.org/10.1097/brs.0000000000002065 |
| رقم الانضمام: | edsair.doi.dedup.....7858b7cf1eeec3cec2d285dc16830e3c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15281159 03622436 |
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| DOI: | 10.1097/brs.0000000000002065 |