What would you do first? A survey of treatment priorities for patients with hip-spine syndrome among spine and hip surgeons

BackgroundThe optimal sequence of hip and spine surgeries for hip-spine syndrome management remains a contentious issue. This study aimed to investigate the preferences and rationale behind the sequence of surgical treatments across various hip-spine syndrome scenarios among potential specialist interviewees. MethodsA questionnaire survey, featuring five fictional clinical presentations encompassing symptomatic hip osteoarthritis and diverse spinal pathologies, was conducted among German hip and spine surgeons, alongside conducting a cross-national comparison with previous US survey. ResultsGerman hip and spine surgeons preferred spine-first surgery in hip-spine syndrome scenarios involving neurological deficits, while preferred hip-first in scenarios without such deficits. In contrast, US surgeons demonstrated differing sequencing patterns, highlighting differences between nations. Notably, distinct surgical order preferences were observed among different specialists. Surgeons decision-making was primarily influenced by symptom severity and urgency, spine-pelvis-hip biomechanics, and treatment efficacy. ConclusionThe sequence of hip and spine surgery in various hip-spine syndrome scenarios has different preference patterns, with professional preferences and cross-nation differences, and is guided by the multifaceted considerations involved in surgical decision-making.