Evaluating compliance with the best practice guidelines for wrong-level surgery prevention in high-risk pediatric spine surgery

期刊论文
发表日期：

2024年3月21日

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Alondra Concepción-González,
J. Manuel Sarmiento,
Christina C. Rymond,
Chinenye Ezeh,
Rishi Sinha,
Hannah Lin,
Kevin Lu,
Afrain Z. Boby,
Prakash Gorroochurn,
A. Noelle Larson,
Benjamin D. Roye,
Brice Ilharreborde,
Michael G. Vitale,
Regina Wood,
Michelle Marks,
Carol Hasler,
René Castelein,
Sébastien Pesenta,
Ilkka Helenius,
Dror Ovadia,
David Farrington,
Muharrem Yazici,
Moyo Kruyt,
Jorge Mineiro,
Oliana Madeira

摘要

Purpose

In 2018, Best Practice Guidelines (BPGs) were published for preventing wrong-level surgery in pediatric spinal deformity, but successful implementation has not been established. The purpose of this study was to evaluate BPG compliance 5 years after publication. We hypothesized higher compliance among BPG authors and among surgeons with more experience, higher caseload, and awareness of the BPGs.

Methods

We queried North American and European surgeons, authors and nonauthors, and members of pediatric spinal study groups on adherence to BPGs using an anonymous survey consisting of 18 Likert scale questions. Respondents provided years in practice, yearly caseload, and guideline awareness. Mean compliance scores (MCS) were developed by correlating Likert responses with MCS scores (“None of the time” = no compliance = MCS 0, “Sometimes” = weak to moderate = MCS 1, “Most of the time” = high = MCS 2, and “All the time” = perfect = MCS 3).

Results

Of the 134 respondents, 81.5% reported high or perfect compliance. Average MCS for all guidelines was 2.4 ± 0.4. North American and European surgeons showed no compliance differences (2.4 vs. 2.3, p = 0.07). Authors and nonauthors showed significantly different compliance scores (2.8 vs 2.4, p < 0.001), as did surgeons with and without knowledge of the BPGs (2.5 vs 2.2, p < 0.001). BPG awareness and compliance showed a moderate positive correlation (r = 0.48, p < 0.001), with non-significant associations between compliance and both years in practice (r = 0.41, p = 0.64) and yearly caseload (r = 0.02, p = 0.87).

Conclusion

Surgeons reported high or perfect compliance 81.5% of the time with BPGs for preventing wrong-level surgery. Authorship and BPG awareness showed increased compliance. Location, study group membership, years in practice, and yearly caseload did not affect compliance.

Level of evidence

Level V—expert opinion.