Differences in Perioperative Management of Patients Undergoing Complex Spine Surgery: A Global Perspective.

TitleDifferences in Perioperative Management of Patients Undergoing Complex Spine Surgery: A Global Perspective.
Publication TypeJournal Article
Year of Publication2023
AuthorsBlacker SN, Woody N, Shiferaw AAbate, Burbridge M, Bustillo MA, Hazard SW, Heller BJ, Lamperti M, Mejia-Mantilla J, Nadler JW, Rath GPrasad, Robba C, Vincent A, Admasu AK, Awraris M, Lele AV
JournalJ Neurosurg Anesthesiol
Date Published2023 May 16

BACKGROUND: The aim of this survey was to understand institutional spine surgery practices and their concordance with published best practices/recommendations.

METHODS: Using a global internet-based survey examining perioperative spine surgery practice, reported institutional spine pathway elements (n=139) were compared with the level of evidence published in guideline recommendations. The concordance of clinical practice with guidelines was categorized as poor (≤20%), fair (21%-40%), moderate (41%-60%), good (61%-80%), or very good (81%-100%).

RESULTS: Seventy-two of 409 (17.6%) institutional contacts started the survey, of which 31 (7.6%) completed the survey. Six (19.4%) of the completed surveys were from respondents in low/middle-income countries, and 25 (80.6%) were from respondents in high-income countries. Forty-one incomplete surveys were not included in the final analysis, as most were less than 40% complete. Five of 139 (3.6%) reported elements had very good concordance for the entire cohort; hospitals with spine surgery pathways reported 18 elements with very good concordance, whereas institutions without spine surgery pathways reported only 1 element with very good concordance. Reported spine pathways included between 7 and 47 separate pathway elements. There were 87 unique elements in the reviewed pathways. Only 3 of 87 (3.4%) elements with high-quality evidence demonstrated very good practice concordance.

CONCLUSIONS: This global survey-based study identified practice variation and low adoption rates of high-quality evidence in the care of patients undergoing complex spine surgery.

Alternate JournalJ Neurosurg Anesthesiol
PubMed ID37192477