Department of Orthopaedic Surgery, Howard University College of Medicine, Washington, District of Columbia, USA.
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA.
World Neurosurg. 2023 Jul;175:e1005-e1010. doi: 10.1016/j.wneu.2023.04.060. Epub 2023 Apr 20.
Two general pathways exist for spine surgery training in the United States: orthopedic surgery and neurological surgery. Previous studies have not quantified the impact of fellowship training when comparing case volumes between these 2 training pathways. This study compares reported spine surgery case volume upon graduation from orthopedic surgery and neurological surgery training.
This was a retrospective cohort study of recent graduates from orthopedic surgery and neurological Surgery training programs in the United States (2018-2021). The Accreditation Council for Graduate Medical Education provided case logs for residents in neurological surgery and orthopedic surgery as well as fellows in orthopedic spine surgery. Case volumes were compared for adult and pediatric spine surgery cases using parametric tests.
Case logs from 3146 orthopedic surgery residents, 107 orthopedic spine surgery fellows, and 766 neurological surgery residents were included in this study. Across each cohort, neurological surgery trainees reported more total adult spine surgery cases than orthopedic surgery trainees (514 ± 206 vs. 383 ± 171, P < 0.001). Orthopedic surgery trainees reported more total pediatric spine surgery cases (21 ± 14 vs. 17 ± 12, P = 0.006).
Neurological surgery training affords a greater volume of adult spine surgery cases, but orthopedic surgery affords more pediatric spine surgery cases. Identification of relative strengths and weaknesses can help facilitate multidisciplinary training experiences in spine surgery.
美国脊柱外科培训有两种主要途径:骨科和神经外科。既往研究在比较这两种培训途径的病例量时,并未量化 Fellowship 培训的影响。本研究比较了骨科和神经外科培训毕业后报告的脊柱外科病例量。
这是一项在美国骨科和神经外科培训项目的应届毕业生(2018-2021 年)的回顾性队列研究。研究生医学教育认证委员会为神经外科和骨科住院医师以及骨科脊柱外科研究员提供了病例记录。使用参数检验比较成人和儿童脊柱手术病例的数量。
本研究纳入了 3146 名骨科住院医师、107 名骨科脊柱外科研究员和 766 名神经外科住院医师的病例记录。在每个队列中,神经外科受训者报告的成人脊柱手术总病例数多于骨科受训者(514±206 与 383±171,P<0.001)。骨科住院医师报告的儿童脊柱手术总病例数更多(21±14 与 17±12,P=0.006)。
神经外科培训提供了更多的成人脊柱手术病例,但骨科培训提供了更多的儿童脊柱手术病例。确定相对优势和劣势有助于促进脊柱外科的多学科培训经验。