Insights into Professional Preferences and Rationale for Surgical Sequencing in Managing Hip-Spine Syndrome

Background The 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. Methods A 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. Results German 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. Conclusion The 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.