A new study published in Spine examines the gap between surgical decision making and multidisciplinary team decision making for lumbar degenerative spine disease.
Study authors implemented a multidisciplinary conference at Virginia Mason Medical Center that included neurosurgeons, orthopedic spine surgeons, anesthesiologists, physical therapists, physiatrists and nursing staff and presented patients considered for spinal fusion, or those with complex histories. The multidisciplinary group made a recommendation on whether to proceed with surgery. The researchers compared the group's decision to decisions made by surgeons alone.
The group reviewed 137 consecutive patients over a 10-month period. The study authors found:
1. The outside surgeon recommended 100 patients for lumbar spinal fusion. However, the consensus opinion of the multidisciplinary group was nonoperative management for 58 of those patients.
2. Physicians revised surgical treatment after the conference in 28 percent of the patients who ultimately decided to undergo surgery.
3. There weren't any complications reported among those who did undergo surgery.
4. Study authors concluded, "Isolated surgical decision making may result in suboptimal treatment recommendations. Multidisciplinary conferences can reduce the utilization of lumbar spinal fusion, possibly resulting in more appropriate use of surgical interventions with better candidate selection while providing patients with more diverse nonoperative treatment options."
5. Multidisciplinary care can improve the value of spine care in general.