Institutions investigating value and quality emphasize utilization of two attending surgeons with different areas of technical expertise to treat complex surgical cases and to minimize complications. Here, the authors chronicle the 12-year experience of using a two–attending surgeon, two-specialty model to perform hemivertebra resection in the pediatric population.

Retrospective cohort data from 2008 to 2019 were obtained from the NewYork-Presbyterian Morgan Stanley Children’s Hospital operative database. This database included all consecutive pediatric patients < 21 years old who underwent hemivertebra resection performed with the two–attending surgeon (neurosurgeon and orthopedic surgeon) model. Demographic information was extracted. Intraoperative complications, including durotomy and direct neurological injury, were queried from the clinical records. Intraoperative neuromonitoring data were evaluated. Postoperative complications were queried, and length of follow-up was determined from the clinical records.

From 2008 to 2019, 22 patients with a median (range) age of 9.1 (2.0–19.3) years underwent hemivertebra resection with the two–attending surgeon, two-specialty model. The median (range) number of levels fused was 2 (0–16). The mean (range) operative time was 5 hours and 14 minutes (2 hours and 59 minutes to 8 hours and 30 minutes), and the median (range) estimated blood loss was 325 (80–2700) ml. Navigation was used in 14% (n = 3) of patients. Neither Gardner-Wells tongs nor halo traction was used in any operation. Neuromonitoring signals significantly decreased or were lost in 14% (n = 3) of patients. At a mean ± SD (range) follow-up of 4.6 ± 3.4 (1.0–11.6) years, 31% (n = 7) of patients had a postoperative complication, including 2 instances of proximal junctional kyphosis, 2 instances of distal junctional kyphosis, 2 wound complications, 1 instance of pseudoarthrosis with hardware failure, and 1 instance of screw pullout. The return to the operating room (OR) rate was 27% (n = 6), which included patients with the abovementioned wound complications, distal junctional kyphosis, pseudoarthrosis, and screw pullout, as well as a patient who required spinal fusion after loss of motor evoked potentials during index surgery.

Twenty-two patients underwent hemivertebra resection with a two–attending surgeon, two-specialty model over a 12-year period at a specialized children’s hospital, with a 14% rate of change in neuromonitoring, 32% rate of nonneurological complications, and a 27% rate of unplanned return to the OR.

研究价值和质量的机构强调利用具有不同技术专长领域的两名主治外科医生来治疗复杂的手术病例并尽量减少并发症。在这里，作者记录了 12 年使用两名外科医生、两名专科模型在儿科人群中进行半椎体切除术的经验。

2008 年至 2019 年的回顾性队列数据来自纽约长老会摩根士丹利儿童医院手术数据库。该数据库包括所有连续接受半椎体切除术的小于 21 岁的儿科患者，这些患者采用两人值班外科医生（神经外科医生和整形外科医生）模型进行。提取了人口统计信息。从临床记录中查询术中并发症，包括硬膜切开术和直接神经损伤。评估了术中神经监测数据。询问术后并发症，并根据临床记录确定随访时间。

从 2008 年到 2019 年，22 名中位（范围）年龄为 9.1 (2.0-19.3) 岁的患者在两位主治外科医生、双专科模式下接受了半椎体切除术。融合水平的中位数（范围）数为 2 (0-16)。平均（范围）手术时间为 5 小时 14 分钟（2 小时 59 分钟至 8 小时 30 分钟），估计失血量中位数（范围）为 325 (80–2700) ml。14% (n = 3) 的患者使用了导航。在任何操作中均未使用 Gardner-Wells 夹钳和 Halo 牵引。14% (n = 3) 的患者的神经监测信号显着降低或丢失。在 4.6 ± 3.4 (1.0–11.6) 年的平均 ± SD（范围）随访中，31% (n = 7) 的患者出现术后并发症，包括 2 例近端交界处后凸，2 例远端交界后凸, 2 伤口并发症, 1 例假关节硬件故障，1 例螺钉拔出。返回手术室 (OR) 的比率为 27% (n = 6)，其中包括出现上述伤口并发症、远端关节后凸、假关节和螺钉拔出的患者，以及一名在骨丢失后需要脊柱融合的患者。索引手术期间的运动诱发电位。

22 名患者在 12 年的时间里在一家专门的儿童医院接受了 12 年期间由两名外科医生主诊的半椎体切除术，神经监测的变化率为 14%，非神经系统并发症的发生率为 32%，以及 27计划外返回手术室的百分比。