Assessment of variability in Turkish spine surgeons' trauma practices

Abstract

Objectives: The aim of this study was to analyse the variability among Turkish spinal surgeons in themanagement of thoracolumbar fractures by carrying out a web survey.Methods: An invitation text and web-link of the survey were sent to the members of the Turkish SpineSociety mail group. AŞctitious spine trauma vignette, a 23 year-old male with a L1 burst fracture, waspresented and 25 questions were asked to participants. Variability of answers in a given question wasassessed with the Index of Qualitative Variation (IQV). Questions with high IQV values (>%80) wereselected to evaluate the relation between participant factors (speciality, age, degree and experience levelof the surgeon, type of the work centre and volume of the trauma patients).Results: Sixty-four (88%) among the 73 participating surgeons completed the survey. 45 (70%) of themwere orthopaedic surgeons and 19 (30%) were neurosurgeons. 11 questions had very high variability(IQV 0.80), 5 had high variability (0.58e0.75) and 2 had low variability (IQV 0.20). The question withthe highest variability was related to the use of brace after surgery (IQV¼ 0.93). Following one was aboutthe selection ofŞxation levels (IQV ¼ 0.91). Neurosurgeons were more likely to use brace postoperativelyand professors were less likely to perform decompression.Conclusion: This survey shows that thoracolumbar spine trauma practice signiŞcantly varies amongTurkish spine surgeons. Surgeons' characteristics affected some speciŞc answers. Lack of enoughknowledge about spine trauma care, fracture classiŞcations and surgical techniques and/or ethical factorsmay be other reasons for this variability.© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).