Preoperative Spine Evaluation and Assessment

INTRODUCTION

This clinical guideline was created to improve patient care by outlining the appropriate information gathering and decision-making processes involved in the treatment of patients with perioperative spinal disease. Spinal surgical care is provided in many different settings by many different providers. Spine surgeries are often performed to treat painful spinal conditions and rates of spine surgery have increased over time. This guideline was created as an educational tool to guide qualified physicians through a series of diagnostic and treatment decisions to improve the quality and efficiency of care.

This guideline addresses the following preoperative topics related to perioperative spinal disease: if duration and dose of preoperative opioids or preoperative opioid weaning is associated with patient-reported outcomes or adverse events after elective spine surgery for degenerative conditions; if preoperative patient factors of diabetes, smoking, and increased BMI impact surgical outcomes; develop guidelines for the preoperative assessment and treatment of osteoporosis in patients undergoing spine surgery; determine which assessments of nutritional status were associated with specific adverse events after spine surgery, and if a preoperative nutritional improvement intervention may be beneficial in lowering the rates of these adverse events; and determine preoperative risk factors for perioperative and postoperative pulmonary adverse events, and to determine the optimal preoperative evaluation and management of at-risk patients.

This guideline should not be construed as including all proper methods of care or excluding methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment must be made in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution.

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