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首页> 外文期刊>Acta Neurochirurgica >Association of decision-making in spinal surgery with specialty and emotional involvement—the Indications in Spinal Surgery (INDIANA) survey
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Association of decision-making in spinal surgery with specialty and emotional involvement—the Indications in Spinal Surgery (INDIANA) survey

机译：专业和情感参与的脊柱手术中决策协会 - 脊髓外科（印第安纳州）调查中的迹象

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Abstract Background Although recent trials provided level I evidence for the most common degenerative lumbar spinal disorders, treatment still varies widely. Thus, the Indications in Spinal Surgery (INDIANA) survey explores whether decision-making is influenced by specialty or personal emotional involvement of the treating specialist. Method Nationwide, neurosurgeons and orthopedic surgeons specialized in spine surgery were asked to answer an Internet-based questionnaire with typical clinical patient cases of lumbar disc herniation (DH), lumbar spinal stenosis (SS), and lumbar degenerative spondylolisthesis (SL). The surgeons were assigned to counsel a patient or a close relative, thus creating emotional involvement. This was achieved by randomly allocating the surgeons to a patient group (PG) and relative group (RG). We then compared neurosurgeons to orthopedic surgeons and the PG to the RG regarding treatment decision-making. Results One hundred twenty-two spine surgeons completed the questionnaire (response rate 78.7%). Regarding DH and SS, more conservative treatment among orthopedic surgeons was shown (DH: odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7–9.7, p ?=?0.001; SS: OR 3.9, CI 1.8–8.2, p ? p ?=?0.213; SS: p ?=?0.097; SL: p ?=?0.924). Conclusions The high response rate indicates how important the issues raised by this study actually are for dedicated spine surgeons. Moreover, there are considerable variations in decision-making for the most common degenerative lumbar spinal disorders, although there is high-quality data from large multicenter trials available. Emotional involvement, though, did not influence treatment recommendations.
机译：摘要背景虽然最近的试验提供了我最常见的退行性腰椎疾病的证据，但治疗仍然差异很大。因此，脊柱手术（印第安纳州）调查中的适应症探讨了决策是否受到治疗专家的特殊或个人情感参与的影响。脊椎外科专业的全国范围内的方法，被要求回答基于互联网的临床患者患者的腰椎间盘突出症（DH），腰椎狭窄（SS）和腰椎退行性脊椎细胞度过（SL）。将外科医生分配给患者或密切相关，从而产生情绪参与。这是通过将外科医生随机分配给患者组（PG）和相对组（RG）来实现。然后，我们将神经外部与整形外科医生进行比较，并将PG与RG关于治疗决策。结果一百二十二脊椎外科医生完成了调查问卷（响应率78.7％）。关于DH和SS，显示矫形外科医生之间的更保守的处理（DH：差距[或] 4.1,95％置信区间[CI] 1.7-9.7，P？= 0.001; SS：或3.9，CI 1.8-8.2， p？p？= 0.213; ss：p？= 0.097; sl：p？= 0.924）。结论高响应率表示本研究提出的问题实际上是多么重要的是专用脊柱外科医生。此外，对于最常见的退行性腰椎障碍有相当多的决策变化，尽管有来自大型多中心试验的高质量数据。但是，情绪化的参与并没有影响治疗建议。

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