For a study, the researchers sought to determine if intraoperative staff changes and surgical case orders could predict intraoperative timing extensions after spine surgery for spondylotic disorders. Researchers conducted a retrospective cohort analysis. Between 2017 and 2019, all patients over 18 who received primary or revision decompression and fusion for degenerative spinal diseases at a single academic institution were identified retrospectively. The absence of descriptive data and intraoperative time parameters, as well as surgery for severe damage, infection, or malignancy, were all exclusion criteria. Total theatre time, wheels into induction, induction start to cut, cut to close, and close to wheels out were all intraoperative timing measures. The length of hospital stay (LOS) and 90-day hospital readmissions were postoperative outcomes. The surgical case order was identified, and intraoperative changes in staff (circulator and surgical scrub nurse or technician). The patients’ demographics, surgical variables, intraoperative time, and postoperative results were all documented. Extensions were calculated as a ratio of the actual duration of the parameter divided by the projected length of the parameter in each operating stage. Univariate and multivariate analyses were used to compare outcomes within case order and staff change groups. A total of 1,108 patients met the criteria for inclusion. The intraoperative extensions of total theatre time, wheels into induction, induction start to cut, cut to close, and close to wheels out differed considerably between the first, second, and third start cases. Regression analysis revealed that declining case order predicted wheel extension in induction time. Total theatre time, induction start to cut time, cut to close time, close to wheels out time, and LOS all increased after surgeries with intraoperative personnel changes. The change in the significant circulation resulted in a longer theatre time and a shorter time to close. Extended total theatre time, induction start to cut time, cut to approach time, and close to wheels out time were all projected when the primary circulator or scrub was relieved. Intraoperative staff changes in spine surgery were an independent predictor of longer operative times. On the other hand, higher case order had no meaningful relationship with procedural time.
Link:www.thespinejournalonline.com/article/S1529-9430(22)00037-7/fulltext
