Complication avoidance with pre-operative screening: insights from the Seattle spine team.
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.
Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA.
Quinlan D
QD
Buchlak
Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA.
Vijay
V
Yanamadala
Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA.
Jean-Christophe
JC
Leveque
Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA. rajiv.sethi@virginiamason.org.|Department of Health Services, University of Washington, Seattle, WA, USA. rajiv.sethi@virginiamason.org.
Rajiv
R
Sethi
Adult lumbar scoliosis; Multidisciplinary patient care; Risk mitigation; Risk stratification; Spine surgery; Surgical risk management