Complication Avoidance with Pre-operative Screening: Insights from the Seattle Spine Team

Overview

Journal Curr Rev Musculoskelet Med

Date 2016 Jun 5

PMID 27260267

Citations 16

Authors

Quinlan D Buchlak

Vijay Yanamadala

Jean-Christophe Leveque

Rajiv Sethi

Affiliations

Soon will be listed here.

Abstract

Complication rates for complex adult lumbar scoliosis surgery are unacceptably high. Standardized preoperative evaluation protocols have been shown to significantly reduce the likelihood of a spectrum of negative outcomes associated with complex adult lumbar scoliosis surgery. To increase patient safety and reduce complication risk, an entire medical and surgical team should work together to care for adult lumbar scoliosis patients. This article describes preoperative patient evaluation strategies with a particular focus on adult lumbar scoliosis surgery involving six or more levels of spinal fusion. Domains considered include recent preoperative evaluation literature, predictive risk modeling, the appropriate management of medical conditions, and the composition and activities of a multidisciplinary conference review team. An evidence-based comprehensive systematic preoperative surgical evaluation process is described.

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References

Yu X, Xiao H, Wang R, Huang Y . Prediction of massive blood loss in scoliosis surgery from preoperative variables. Spine (Phila Pa 1976). 2012; 38(4):350-5. DOI: 10.1097/BRS.0b013e31826c63cb. View

Jiang J, Teng Y, Fan Z, Khan S, Xia Y . Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis. Clin Orthop Relat Res. 2013; 472(3):968-75. PMC: 3916601. DOI: 10.1007/s11999-013-3346-3. View

Modi H, Suh S, Hong J, Song S, Yang J . Intraoperative blood loss during different stages of scoliosis surgery: A prospective study. Scoliosis. 2010; 5:16. PMC: 2924263. DOI: 10.1186/1748-7161-5-16. View

Allen R, Rihn J, Glassman S, Currier B, Albert T, Phillips F . An evidence-based approach to spine surgery. Am J Med Qual. 2009; 24(6 Suppl):15S-24S. DOI: 10.1177/1062860609348743. View

Ellis D, Mallozzi S, Mathews J, Moss I, Ouellet J, Jarzem P . The Relationship between Preoperative Expectations and the Short-Term Postoperative Satisfaction and Functional Outcome in Lumbar Spine Surgery: A Systematic Review. Global Spine J. 2015; 5(5):436-52. PMC: 4577329. DOI: 10.1055/s-0035-1551650. View

Ames C, Barry J, Keshavarzi S, Dede O, Weber M, Deviren V . Perioperative Outcomes and Complications of Pedicle Subtraction Osteotomy in Cases With Single Versus Two Attending Surgeons. Spine Deform. 2016; 1(1):51-58. DOI: 10.1016/j.jspd.2012.10.004. View

Halpin R, Sugrue P, Gould R, Kallas P, Schafer M, Ondra S . Standardizing care for high-risk patients in spine surgery: the Northwestern high-risk spine protocol. Spine (Phila Pa 1976). 2010; 35(25):2232-8. DOI: 10.1097/BRS.0b013e3181e8abb0. View

Bekelis K, Desai A, Bakhoum S, Missios S . A predictive model of complications after spine surgery: the National Surgical Quality Improvement Program (NSQIP) 2005-2010. Spine J. 2013; 14(7):1247-55. DOI: 10.1016/j.spinee.2013.08.009. View

Lee M, Cizik A, Hamilton D, Chapman J . Predicting medical complications after spine surgery: a validated model using a prospective surgical registry. Spine J. 2013; 14(2):291-9. PMC: 4012388. DOI: 10.1016/j.spinee.2013.10.043. View

10.

Drazin D, Shirzadi A, Rosner J, Eboli P, Safee M, Baron E . Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions. Neurosurg Focus. 2011; 31(4):E3. DOI: 10.3171/2011.7.FOCUS11145. View

11.

Glassman S, Hamill C, Bridwell K, Schwab F, Dimar J, Lowe T . The impact of perioperative complications on clinical outcome in adult deformity surgery. Spine (Phila Pa 1976). 2007; 32(24):2764-70. DOI: 10.1097/BRS.0b013e31815a7644. View

12.

Chapin L, Ward K, Ryken T . Preoperative Depression, Smoking, and Employment Status are Significant Factors in Patient Satisfaction After Lumbar Spine Surgery. Clin Spine Surg. 2017; 30(6):E725-E732. DOI: 10.1097/BSD.0000000000000331. View

13.

Jackson R, SIMMONS E, Stripinis D . Coronal and sagittal plane spinal deformities correlating with back pain and pulmonary function in adult idiopathic scoliosis. Spine (Phila Pa 1976). 1989; 14(12):1391-7. DOI: 10.1097/00007632-198912000-00018. View

14.

Theologis A, Burch S . Prevention of Acute Proximal Junctional Fractures After Long Thoracolumbar Posterior Fusions for Adult Spinal Deformity Using 2-level Cement Augmentation at the Upper Instrumented Vertebra and the Vertebra 1 Level Proximal to the Upper Instrumented.... Spine (Phila Pa 1976). 2015; 40(19):1516-26. DOI: 10.1097/BRS.0000000000001043. View

15.

Cho S, Bridwell K, Lenke L, Yi J, Pahys J, P Zebala L . Major complications in revision adult deformity surgery: risk factors and clinical outcomes with 2- to 7-year follow-up. Spine (Phila Pa 1976). 2011; 37(6):489-500. DOI: 10.1097/BRS.0b013e3182217ab5. View

16.

Baldus C, Bridwell K, Lenke L, Okubadejo G . Can we safely reduce blood loss during lumbar pedicle subtraction osteotomy procedures using tranexamic acid or aprotinin? A comparative study with controls. Spine (Phila Pa 1976). 2010; 35(2):235-9. DOI: 10.1097/BRS.0b013e3181c86cb9. View

17.

Buerba R, Fu M, Gruskay J, Long 3rd W, Grauer J . Obese Class III patients at significantly greater risk of multiple complications after lumbar surgery: an analysis of 10,387 patients in the ACS NSQIP database. Spine J. 2013; 14(9):2008-18. DOI: 10.1016/j.spinee.2013.11.047. View

18.

Rampersaud Y, Moro E, Neary M, White K, Lewis S, Massicotte E . Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols. Spine (Phila Pa 1976). 2006; 31(13):1503-10. DOI: 10.1097/01.brs.0000220652.39970.c2. View

19.

Sansur C, Smith J, Coe J, Glassman S, Berven S, Polly Jr D . Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976). 2011; 36(9):E593-7. DOI: 10.1097/BRS.0b013e3182059bfd. View

20.

Joy B, Elliott E, Hardy C, Sullivan C, Backer C, Kane J . Standardized multidisciplinary protocol improves handover of cardiac surgery patients to the intensive care unit. Pediatr Crit Care Med. 2010; 12(3):304-8. DOI: 10.1097/PCC.0b013e3181fe25a1. View