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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.
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