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Surgical Outcomes 2018-06-07T15:47:17+00:00

Surgical Outcomes

When considering spine surgery, it is important to evaluate a spine surgeon’s success and complication rates. One option is to check with web-based physician rating companies, but in general, they rely on data from Medicare and based on a physician’s practice, this may not reflect his or her practice volume or insurance mix. A better option is to have your surgeon’s outcomes determined by a third-party survey.

At my practice, we work in partnership with Denver Spine Surgeons and use web-based patient surveys that look at pain control, return to work and recreational activities.

Local hospitals also gather data but do not report a specific surgeon’s outcomes. Locating the surgeons with the least number of complications and higher success rates can be difficult. Most often the Internet reflects opinions volunteered by patients. It is important to know the rate of infections, re-admissions within 30 days of the original operation, complications, and re-operations immediately after the first surgery compared to published national standards. In addition, the complexity of the surgery and the high risk patients that a surgeon operates on are also important factors to consider.

Outcomes 2016

Below are my 2016 outcomes data for all surgeries performed (173) on the cervical spine (neck) and lumbar spine (low back), including:

  • Microdiscectomy lamiminotomy-foraminotomoy
  • Laminoplasty (neck)
  • Spinal Fusion of the neck and back
  • Surgery for Spondylolisthesis (slipped vertebrae)
  • Artificial Disc Replacement of the neck
  • Revision Surgery for non-union, spinal stenosis, next level disease
  • Instrumentation of the cervical, thoracic, and lumbar spine
  • Removal of Spinal Instrumentation
  • Spinal Cord Stimulator placement

RESULTS

  • Infection rate: 0, 0% (Range: 1.4 – 4.2%)
  • Re-admission within 30 days of first surgery: 0%
  • NEW Neurologic weakness more than 6 months: (1), 0.6%
  • Bleeding after surgery (hematoma) requiring repeat surgery: 0%
  • Dural Tear requiring repeat surgery: (1), 0.6% (Range 0.8 – 7.2%)
  • Recurrent Disc Herniation requiring surgery: 0%
  • Eye complications: 0% (Range less than 0.2%)
  • Vocal Cord Paralysis: 0% (Range less than or equal to 5%)
  • Non-union of spinal fusion (1), Implant failure (1), next level degeneration (1): 1.8%
  • Extended hospital stay due to gastro-intestinal problems (2): 1.2%

Outcomes 2015

Below are my 2015 outcomes data for all surgeries performed (265) on the cervical spine (neck), lumbar spine (low back), and deformity (scoliosis, kyphosis), including:

  • Microdiscectomy lamiminotomy-foraminotomoy
  • Laminoplasty (neck)
  • Spinal Fusion of the neck and back
  • Surgery for Scoliosis, Kyphosis
  • Surgery for Spondylolisthesis (slipped vertebrae)
  • Artificial Disc Replacement of the neck and low back
  • Revision Surgery for non-union, spinal stenosis, next level disease
  • Instrumentation of the cervical, thoracic, and lumbar spine
  • Removal of Spinal Instrumentation
  • Spinal Cord Stimulator placement

RESULTS

  • Infection rate: 3 patients, 1.1% (Range: 1.4 – 4.2%)
  • Re-admission within 30 days of first surgery: 7 patients, 2.6%
    • 3 patients for pain management
    • 3 patients for infection
    • 1 patient for spinal fluid leak requiring repair
  • NEW Neurologic weakness more than 6 months: one patient, 0.4%
  • Bleeding after surgery (hematoma) requiring repeat surgery: 0%
  • Dural Tear requiring repeat surgery: one patient, 0.4% (Range 0.8 – 7.2%)
  • Recurrent Disc Herniation requiring surgery: 12.9% (Range 2 – 18%)
  • Eye complications: 0% (Range less than 0.2%)
  • Mortality: medical complication not procedure related: one patient, respiratory compromise
  • Vocal Cord Paralysis: 0% (Range less than or equal to 5%)

Return to Function Outcomes & Patient Satisfaction

The trend in medicine is to explore nonsurgical solutions to various health problems. The same trend is occurring in the area of spine care.

Dr. Sanjay Jatana uses written protocols that emphasize a nonsurgical approach first, and surgery is held as the last resort.

The TRUE definition of quality is reduction of variation about the mean. As quality experts note, unless you have data, you simply have no business talking about quality. New patients coming into Denver Spine Surgeons completed a clinical outcome tool that measured their pain level, severity of symptoms and functional status. Three months after their first visit, a nurse called a random sample of these patients and interviewed them for functional status, current symptoms and patient satisfaction. This is the most unbiased, statistically relevant method for outcomes analysis.

The clinical outcomes presented here are analyzed by an outside firm that specializes in tracking spine outcomes, and is the most experienced entity nationally in spine center development. The results show that Denver Spine Surgeons receives at its front door the most complex patient base in the region. One in four new patients to Denver Spine Surgeons had previous back surgery, and 72% had suffered from back or neck pain for more than four months. More than one-third of all new patients had serious neurological symptoms like numbness and pain beyond a knee or elbow, which can imply a 89% of simple and chronic patients returned to work. As to patient satisfaction, Denver Spine Surgeons averaged above 99% for all seven categories measured, and 99% were happy with the amount of time the doctor spent with them.

Quality is a journey, however, rather than a destination, and we are committed to continually improving. This report documents our footprints on that journey.

Pain relief through function

The main reason people go to the doctor is for relief of pain. But if a spine clinic focuses exclusively on pain, it can miss the target of return to function. A spine specialized physical therapist provides pain relief and then moves the patient quickly into supervised exercise. This chart shows that Denver Spine Surgeons has good success relieving pain, eliminating numbness and radiating pain in legs or arms, and ultimately returning the back pain sufferer to activity — after only three months of care. The gains in function did not come from pills either. For example, the percent of patients relying heavily on pills for pain control declined from 21% to 7% after three months. Self-reported pain levels decreased, as did patient-reported limitations related to carrying groceries, climbing stairs and standing for a half hour.