TY - JOUR
T1 - Assessment of surgeons’ attitude towards awake spine surgery under spinal anesthesia
AU - De Biase, Gaetano
AU - Carter, Rickey E.
AU - Otamendi-Lopez, Andrea
AU - Garcia, Diogo
AU - Chen, Selby
AU - Bojaxhi, Elird
AU - Quinones-Hinojosa, Alfredo
AU - Abode-Iyamah, Kingsley
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2023/1
Y1 - 2023/1
N2 - Background: General anesthesia (GA) and spinal anesthesia (SA) have been adopted for lumbar spine surgery (LSS), but GA is used far more widely. We conducted a survey of spine surgeons to explore their attitudes and preferences regarding awake spine surgery under SA. Methods: A survey was emailed to 150 spine surgeons. Exposure and attitudes towards spine surgery under SA were elicited. A five-point Likert scale of agreement examined perceptions of SA, while attitudes towards SA were recorded by categorizing free text into themes. Results: Seventy-five surgeons completed the survey, 50 % response rate. Only 27 % said they perform LSS under SA. Most surgeons, 83 %, would recommend GA to a healthy patient undergoing lumbar laminectomy. Only 41 % believes SA to be as safe as GA, and only 30 % believes SA is associated with better postoperative pain control. The most common reasons why SA is not favored was lack of proven benefits over GA (65 %). When asked if a randomized trial finds SA to lead to less postoperative fatigue, 50 % said they would be more likely to offer SA, a significant increase from the baseline response of 27 % (p = 0.002). Conclusions: Our survey indicates that the low adoption of SA for LSS is due to lack of surgeons’ belief in the benefits of SA over GA, and that a randomized patient-centered trial has the potential of changing surgeons’ perspective and increasing adoption of SA for LSS.
AB - Background: General anesthesia (GA) and spinal anesthesia (SA) have been adopted for lumbar spine surgery (LSS), but GA is used far more widely. We conducted a survey of spine surgeons to explore their attitudes and preferences regarding awake spine surgery under SA. Methods: A survey was emailed to 150 spine surgeons. Exposure and attitudes towards spine surgery under SA were elicited. A five-point Likert scale of agreement examined perceptions of SA, while attitudes towards SA were recorded by categorizing free text into themes. Results: Seventy-five surgeons completed the survey, 50 % response rate. Only 27 % said they perform LSS under SA. Most surgeons, 83 %, would recommend GA to a healthy patient undergoing lumbar laminectomy. Only 41 % believes SA to be as safe as GA, and only 30 % believes SA is associated with better postoperative pain control. The most common reasons why SA is not favored was lack of proven benefits over GA (65 %). When asked if a randomized trial finds SA to lead to less postoperative fatigue, 50 % said they would be more likely to offer SA, a significant increase from the baseline response of 27 % (p = 0.002). Conclusions: Our survey indicates that the low adoption of SA for LSS is due to lack of surgeons’ belief in the benefits of SA over GA, and that a randomized patient-centered trial has the potential of changing surgeons’ perspective and increasing adoption of SA for LSS.
KW - Awake MIS-TLIF
KW - Awake spine surgery
KW - Patient-centered outcomes
KW - Randomized trials
KW - Spinal anesthesia
KW - Survey
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U2 - 10.1016/j.jocn.2022.12.003
DO - 10.1016/j.jocn.2022.12.003
M3 - Article
C2 - 36502781
AN - SCOPUS:85145022665
SN - 0967-5868
VL - 107
SP - 48
EP - 53
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
ER -