{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:40:14Z","timestamp":1733492414346,"version":"3.30.1"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Policy concern and debate surround the concept of overlapping spine surgery. Overlapping surgery specifically refers to nonessential portions of the case or noncutting time overlap. This differs from concurrent surgery, in which critical portions of the procedure overlap. Here the authors explore the barriers for safe and efficient overlapping surgery in academic spinal deformity practice.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Over a 24-month period, cases of spinal deformity, degenerative cases, anterior cervical discectomy and fusions (ACDFs), and laminectomy were reviewed for duration in operating room (OR) prior to surgery, duration of cutting time, duration in OR after surgery, turnover duration, and time delay from initial start time. Standard degenerative cases were referenced as 1\u20132 ACDFs as well as 1- to 2-level laminectomy surgery. The blocks of time between two consecutive cutting periods were investigated to determine the feasibility of overlapping an additional surgery. Specifically, the authors compared the blocks of time that include the postsurgery period, the turnover period, and the presurgery period to cutting periods.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>One hundred twenty-six complex spinal deformity procedures and 85 degenerative cases (including 49 ACDFs and 36 laminectomies) from one center and one neurosurgeon were reviewed. These procedures were performed between September 2019 and December 2021 with a 3-month gap in military deployment. On average, the procedure\u2019s duration for cases of deformity was 236.5 minutes, for cases of ACDFs it was 84 minutes, and for cases of laminectomies it was 105.5 minutes. The block of noncutting time while the patient was in the OR showed no difference from the surgical cut time. The turnover time between cases was 52.35 minutes. Of 100 cases scheduled as the first case of the day, 94 had a delay to the OR averaging 18.2 minutes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The data in this study indicate that estimates for pre- and postsurgical times alone are not sufficient to allow for overlapping surgery. The average cut-time duration of ACDF was 84 minutes; the average presurgical time for deformity was 68 minutes. This highlights the critical analysis for further examination of optimal scheduling, on-time first start, turnover periods, and the orchestration of all members of the providing team to optimize the cutting time for safe and consistent implementation of overlapping spine surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.2.spine23771","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T01:53:22Z","timestamp":1714182802000},"page":"82-87","source":"Crossref","is-referenced-by-count":0,"title":["Barriers to overlapping complex and general spine surgery at a tertiary academic hospital"],"prefix":"10.3171","volume":"41","author":[{"given":"Noah C.","family":"Baker","sequence":"first","affiliation":[{"name":"University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor A.","family":"Bowden","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony M.","family":"DiGiorgio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier E.","family":"Darbin","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard P.","family":"Menger","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Political Science, University of South Alabama, Mobile, Alabama; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"year":"2016","unstructured":"Position statement on intraoperative responsibility of the primary neurosurgeon. American Association of Neurological Surgeons, American Board of Neurological Surgery, Congress of Neurological Surgeons,. Society of Neurological Surgeons; 2016. Accessed February 20, 2024. https:\/\/www.aans.org\/-\/media\/Files\/AANS\/Advocacy\/PDFS\/Position-Statements\/Neurosurgery-Position-Statement-on-Overlapping-Surgery-FINAL.ashx","article-title":"Position statement on intraoperative responsibility of the primary neurosurgeon. American Association of Neurological Surgeons, American Board of Neurological Surgery, Congress of Neurological Surgeons,","key":"b1"},{"issue":"9","key":"b2","series-title":"Bull Am Coll Surg","first-page":"19","article-title":"American College of Surgeons Statements on Principles","volume":"101","year":"2016","unstructured":"American College of Surgeons Statements on Principles. Bull Am Coll Surg. 2016;101(9):19\u201334."},{"key":"b3","series-title":"The Boston Globe","article-title":"Clash in the name of care","author":"Abelson J","unstructured":"Abelson J, Saltzman J, Kowalczyk L, Allen S. Clash in the name of care. The Boston Globe. Accessed February 20, 2024. https:\/\/apps.bostonglobe.com\/spotlight\/clash-in-the-name-of-care\/story\/"},{"key":"b4","series-title":"The Boston Globe","article-title":"Senate committee calls for ban on surgeons conducting simultaneous operations","author":"Saltzman J","unstructured":"Saltzman J, Abelson J. Senate committee calls for ban on surgeons conducting simultaneous operations. The Boston Globe. December 5, 2016. Accessed February 20, 2024. https:\/\/www.bostonglobe.com\/metro\/2016\/12\/05\/senate-committee-calls-for-ban-surgeons-doing-simultaneous-operations\/EYjO9jiAfLYJsliIrdY4LO\/story.html"},{"key":"b5","series-title":"J Clin Neurosci","first-page":"247","article-title":"The Seattle spine score: predicting 30-day complication risk in adult spinal deformity surgery","volume":"43","author":"Buchlak QD","year":"2017","unstructured":"Buchlak QD, Yanamadala V, Leveque JC, Edwards A, Nold K, Sethi R. The Seattle spine score: predicting 30-day complication risk in adult spinal deformity surgery. J Clin Neurosci. 2017;43:247\u2013255."},{"issue":"1)","key":"b6","series-title":"Harvard Business Review","first-page":"43","article-title":"Disruptive technologies: catching the wave","volume":"73","author":"Bower JL","year":"1995","unstructured":"Bower JL, Christensen CM. Disruptive technologies: catching the wave. Harvard Business Review. 1995;73(1)):43\u201353."},{"issue":"6","key":"b7","series-title":"Oper Neurosurg (Hagerstown)","first-page":"543","article-title":"Change in policy allowing overlapping surgery decreases length of stay in an academic, safety-net hospital","volume":"17","author":"DiGiorgio AM","year":"2019","unstructured":"DiGiorgio AM, Mummaneni PV, Fisher JL,  Change in policy allowing overlapping surgery decreases length of stay in an academic, safety-net hospital. Oper Neurosurg (Hagerstown). 2019;17(6):543\u2013548."},{"issue":"6","key":"b8","series-title":"Neurosurgery","first-page":"E1050","article-title":"Association of overlapping neurosurgery with patient outcomes at a large academic medical center","volume":"85","author":"Agarwal P","year":"2019","unstructured":"Agarwal P, Ramayya AG, Osiemo B,  Association of overlapping neurosurgery with patient outcomes at a large academic medical center. Neurosurgery. 2019;85(6):E1050\u2013E1058."},{"issue":"2","key":"b9","series-title":"J Neurosurg","first-page":"515","article-title":"Impact of a more restrictive overlapping surgery policy: an analysis of pre- and postimplementation complication rates, resident involvement, and surgical wait times at a high-volume neurosurgical department","volume":"129","author":"Guan J","year":"2018","unstructured":"Guan J, Karsy M, Brock AA,  Impact of a more restrictive overlapping surgery policy: an analysis of pre- and postimplementation complication rates, resident involvement, and surgical wait times at a high-volume neurosurgical department. J Neurosurg. 2018;129(2):515\u2013523."},{"key":"b10","series-title":"World Neurosurg","first-page":"658","article-title":"Comparison of patient outcomes and cost of overlapping versus nonoverlapping spine surgery","volume":"100","author":"Zygourakis CC","year":"2017","unstructured":"Zygourakis CC, Sizdahkhani S, Keefe M,  Comparison of patient outcomes and cost of overlapping versus nonoverlapping spine surgery. World Neurosurg. 2017;100:658\u2013664.e8."},{"issue":"5","key":"b11","series-title":"J Neurosurg","first-page":"1096","article-title":"Managing overlapping surgery: an analysis of 1018 neurosurgical and spine cases","volume":"127","author":"Guan J","year":"2017","unstructured":"Guan J, Brock AA, Karsy M,  Managing overlapping surgery: an analysis of 1018 neurosurgical and spine cases. J Neurosurg. 2017;127(5):1096\u20131104."},{"issue":"4","key":"b12","series-title":"JAMA Surg","first-page":"313","article-title":"Association of overlapping surgery with patient outcomes in a large series of neurosurgical cases","volume":"153","author":"Howard BM","year":"2018","unstructured":"Howard BM, Holland CM, Mehta CC,  Association of overlapping surgery with patient outcomes in a large series of neurosurgical cases. JAMA Surg. 2018;153(4):313\u2013321."},{"key":"b13","series-title":"Clin Neurol Neurosurg","first-page":"106610","article-title":"Duration of overlap during lumbar fusion does not predict outcomes","volume":"205","author":"Farooqi AS","year":"2021","unstructured":"Farooqi AS, Borja AJ, Detchou DKE,  Duration of overlap during lumbar fusion does not predict outcomes. Clin Neurol Neurosurg. 2021;205:106610."},{"issue":"1","key":"b14","series-title":"Neurosurgery","first-page":"53","article-title":"Overlapping surgeries are not associated with worse patient outcomes: retrospective multivariate analysis of 14 872 neurosurgical cases performed at a single institution","volume":"83","author":"Bohl MA","year":"2018","unstructured":"Bohl MA, Mooney MA, Sheehy JP,  Overlapping surgeries are not associated with worse patient outcomes: retrospective multivariate analysis of 14 872 neurosurgical cases performed at a single institution. Neurosurgery. 2018;83(1):53\u201359."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/1\/article-p82.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/1\/article-p82.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/1\/article-p82.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:19:21Z","timestamp":1733491161000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/1\/article-p82.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":14,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2024.2.spine23771","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}