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Diversity in Surgical Decision Strategies for Adult Spine Deformity Treatment: The Effects of Neurosurgery or Orthopedic Training Background and Surgical Experience

 Jiin Kang  ;  Naobumi Hosogane  ;  Christopher Ames  ;  Frank Schwab  ;  Robert Hart  ;  Douglas Burton  ;  Christopher Shaffrey  ;  Justin S. Smith  ;  Shay Bess  ;  Virginie Lafage  ;  Kyu-Jung Cho  ;  Yoon Ha  ;  International Spine Study Group and Asian Pacific Spine Study Group 
 Korean Journal of Spine, Vol.15(4) : 353-361, 2018 
Journal Title
Korean Journal of Spine
Issue Date
Kyphosis ; Lordosis ; Neurosurgery ; Operative surgical procedure ; Orthopedics ; Osteotomy

This study is aimed to investigate whether surgical strategies for adult spinal deformity (ASD) treatment differed among Korean physicians.


This study is retrospective questionnaire-based study. ASD is challenging to manage, with a broad range of clinical and radiological presentations. To investigate possible nationality- or ethnicity-related differences in the surgical strategies adopted for ASD treatment, the International Spine Study Group surveyed physicians' responses to 16 cases of ASD. We reviewed the answers to this survey from Korean physicians. Korean orthopedic surgeons (OS) and neurosurgeons (NS) received a questionnaire containing 16 cases and response forms via email. After reviewing the cases, physicians were asked to indicate whether they would treat each case with decompression or fusion. If fusion was chosen, physicians were also asked to indicate whether they would perform 3-column osteotomy. Retrospective chi-square analyses were performed to investigate whether the answers to each question differed according to training specialty or amount of surgical experience.


Twenty-nine physicians responded to our survey, of whom 12 were OS and 17 were NS. In addition, 18 (62.1%) had more than 10 years of experience in ASD correction and were assigned to the M10 group, while 11 (37.9%) had less than 10 years of experience and were assigned to the L10 group. We found that for all cases, the surgical strategies favored did not significantly differ between OS and NS or between the M10 and L10 groups. However, for both fusion surgery and 3-column osteotomy, opinions were divided regarding the necessity of the procedures in 4 of the 16 cases.


The surgical strategies favored by physicians were similar for most cases regardless of their training specialty or experience. This suggests that these factors do not affect the surgical strategies selected for ASD treatment, with patient clinical and radiological characteristics having greater importance.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jiin(강지인)
Ha, Yoon(하윤)
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