Does specialty matter? A survey on 176 Italian neurosurgeons and orthopedic spine surgeons confirms similar competency for common spinal conditions and supports multidisciplinary teams in comprehensive and complex spinal care

Abstract

Background context: Spine surgery is a multifaceted subspeciality requiring a breadth of knowledge and skill from different branches of medicine for the treatment of pathologies varying from degenerative to deformity, oncological, and trauma.

Purpose: The aim of the study was to investigate the self-perceived competency of spine surgeons in relation to different types of spinal procedures.

Study design/setting: This is a survey study.

Methods: We conducted a survey on 176 surgeons (orthopedic surgeons and neurosurgeons). The instrument used for the assessment of the perceived ability was a survey consisting of 21 items (scenarios) developed and distributed through a professional online survey service to ensure confidentiality and anonymity. A newly proposed procedure-specific rating survey was used for the evaluation. Kruskal-Wallis non-parametric test was used to assess validity. A p-value of <.05 was considered statistically significant. A Cronbach α value of >0.8 indicated reliability.

Results: Between the respondents (101), 47.5% were orthopedic surgeons and 52.5% were neurosurgeons. The internal consistency of the questionnaire was satisfactory (Cronbach α=0.93). For common spinal conditions, the orthopedic surgeons and the neurosurgeons perceived a similar competency. The neurosurgeons felt more competent in some cervical conditions (upper cervical procedures, myelopathy) and in neurologic tumors of the spine. The orthopedic surgeons felt more competent in deformities of the spine and in pelvic trauma.

Conclusions: Self-perceived surgical competency for common spinal conditions is similar for orthopedic and neurosurgically trained spine surgeons. For less common conditions and clinical scenarios, the combination of both specialties seems to cover better the full spectrum of surgical care for spinal conditions. Multidisciplinary teams and comprehensive, multidisciplinary spinal surgical training should be considered to provide full coverage of spinal pathology.

Keywords: Information technology; Medical education; Neurosurgery; Orthopedics; Spine; Surgery; Surgical learning; Survey.