Spine Surgeons Vary Considerably in Imaging Practices
(HealthDay News) – Spinal surgeons show considerable variability in imaging practices for elective lumbar spine surgery, according to a study published in the June 15 issue of Spine.
Daniel D. Bohl, MPH, from the Yale School of Medicine in New Haven, CT, surveyed 41 spine surgeons via a one-page questionnaire regarding their current imaging practices for posterior lumbar decompression, posterior lumbar fusion, and anterior lumbar fusion.
The researchers found that, intraoperatively, 75–95% used fluoroscopy, while 5–25% used plain film. In addition, 54–80% of surgeons took images before skin incision, while 59–100% always took final images at the end of the procedure. Postoperatively, 13–54% of surgeons took images after patients had left the operating room but before discharge. Patients were followed up with imaging for a mean of 0.4–1.5 years, with anterior-posterior views for 54–100% of surgeons, lateral views for 56–95% of surgeons, and flexion-extension films for 15–39% of surgeons. For both anterior and posterior fusion, 26% of surgeons routinely assessed fusion by computed tomographic scan.
"Findings highlight extreme variability in practice associated with a notable lack of standard of care and provide a baseline for utility studies that may lead to more evidence-driven care," Bohl and colleagues conclude.