title: Similarities and differences in the treatment of spine trauma between surgical specialties and location of practice.
abstract: METHODS
  Questionnaires administered to practicing orthopedic and neurosurgical spine surgeons from various regions of the United States and abroad.
  
  
  OBJECTIVE
  To determine similarities and differences in the treatment of spinal trauma.
  
  
  BACKGROUND
  Spinal trauma is generally referred to subspecialists of orthopedic or neurosurgical training. Prior studies have suggested that there is significant variability in the management of such injuries.
  
  
  METHODS
  Questionnaires based on eight clinical scenarios of commonly encountered cervical, thoracic, and lumbar injuries were administered to 35 experienced spinal surgeons. Surgeons completed profile information and answered approximately one dozen questions for each case. Data were analyzed with SPSS software to determine the levels of agreement and characteristics of respondents that might account for a lack of agreement on particular aspects of management.
  
  
  RESULTS
  Of the 35 surgeons completing the questionnaire, 63% were orthopedists, 37% were neurosurgeons, and 80% had been in practice for more than 5 years. Considerable agreement was found in the majority of clinical decisions, including whether or not to operate and the timing of surgery. Of the differences noted, neurosurgeons were more likely to obtain a MRI, and orthopedists were more likely to use autograft as a sole graft material. Physicians from abroad were, in general, more likely to operate and to use an anterior approach during surgery than physicians from the northeastern United States.
  
  
  CONCLUSIONS
  More commonalities were identified in the management of spinal trauma than previously reported. When found, variability in opinion was related to professional and regional differences.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA. jonathan.grauer@yale.edu
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Grauer
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: John M
authors.initials: JM
authors.lastname: Beiner
authors.forename: Brian K
authors.initials: BK
authors.lastname: Kwon
authors.forename: Alan S
authors.initials: AS
authors.lastname: Hilibrand
authors.forename: James S
authors.initials: JS
authors.lastname: Harrop
authors.forename: Greg
authors.initials: G
authors.lastname: Anderson
authors.forename: John
authors.initials: J
authors.lastname: Hurlbert
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.forename: Steve C
authors.initials: SC
authors.lastname: Ludwig
authors.forename: Rune
authors.initials: R
authors.lastname: Hedlund
authors.forename: Paul M
authors.initials: PM
authors.lastname: Arnold
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Bono
authors.forename: Darrel S
authors.initials: DS
authors.lastname: Brodke
authors.forename: Marcel F S
authors.initials: MF
authors.lastname: Dvorak
authors.forename: Charles G
authors.initials: CG
authors.lastname: Fischer
authors.forename: John B
authors.initials: JB
authors.lastname: Sledge
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Shaffrey
authors.forename: David G
authors.initials: DG
authors.lastname: Schwartz
authors.forename: William R
authors.initials: WR
authors.lastname: Sears
authors.forename: Curtis
authors.initials: C
authors.lastname: Dickman
authors.forename: Alok
authors.initials: A
authors.lastname: Sharan
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Albert
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Rechtine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D001315:Australia; D001915:Braces; D002170:Canada; D003657:Decision Making; D005060:Europe; D006801:Humans; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000193:education; D009985:Orthopedics / Q000193:education; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016103:Spinal Fractures / Q000601:surgery / Q000628:therapy; D013124:Spinal Injuries / Q000601:surgery / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States