Nationwide Neurosurgical Practice Patterns in Radiology Imaging Report Utilization for Management of Suspected Lumbar Spinal Stenosis

Introduction: Communication between neurosurgeons and neuroradiologists has been decreasing since the implementation of electronic health record systems and remote radiology readings. Our aim was to survey and report the current practices employed by neurosurgeons in utilizing neuroradiology reports for management of patients with lumbar spinal stenosis (LSS).

Methods: An anonymized survey was distributed among academic and private practice neurosurgeons across the United States. Survey questions were aimed at assessing the trends and the subsequent practice patterns in neurosurgical utilization of neuroradiology reports in management of patients with LSS.

Results: 183 unique responses were recorded. 59% of respondents were employed in private practice, 25.7% were practicing in an academic setting and 15.3% were employed elsewhere. 73.5% of respondents reported having easy access to a neuroradiologist with 60.1% reporting a radiologist available on site, while 39.9% reported only off site radiologists. 16.9% of the neurosurgeons read the radiology reports on the imaging they ordered less than 50% of the time, while only 38.6% always read the neuroradiology reports. Key reasons for not reading the ordered reports were confidence in own imaging interpretation (78.1%), lack of standardized grading system and/or excessive report length (40.2%) and lack of trust between neurosurgeon and neuroradiologist (18.9%). 67.9% of the surveyed neurosurgeons reported instances of major discrepancies in imaging interpretation with neuroradiologists in 25% or more of the ordered imaging reports. Only 60.9% of the surveyed neurosurgeons reported contacting the neuroradiologist to discuss such discrepancies. Furthermore, most neurosurgeons do not routinely participate in conferences where imaging is discussed.

Conclusion : The survey results demonstrate that neurosurgeons give little value to neuroradiology reports, do not routinely consult with neuroradiologists, and often ignore major discrepancies in imaging interpretation of the ordered scans. Whether such practices lead to altered surgical outcomes and affect healthcare costs warrants further investigation.