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Modifiable Factors in a Standard Work Protocol for Adult Deformity Surgery

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Value-Based Approaches to Spine Care

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Abstract

As our society ages, the number of people with symptomatic spinal deformity continues to grow. Surgical techniques have evolved to allow correction and stabilization of the deformity; however, our complication rate remains too high. We have outlined eleven patient and intraoperative factors that can be optimized and employed as part of the Standard Work of care that have been shown in the literature to be associated with decreased complications. These include albumin, smoking, bone mineral density (BMD), preoperative hemoglobin, body mass index (BMI), frailty, hemoglobin A1c, mental health, vitamin D, employing spine-specific fluid management algorithms, and use of tranexamic acid.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kansas City Medical Center, Kansas City, KS, USA

    Douglas C. Burton

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  1. Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA

    Rajiv K. Sethi

  2. Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA

    Anna K. Wright

  3. Columbia University, New York, NY, USA

    Michael G. Vitale

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Burton, D.C. (2020). Modifiable Factors in a Standard Work Protocol for Adult Deformity Surgery. In: Sethi, R., Wright, A., Vitale, M. (eds) Value-Based Approaches to Spine Care . Springer, Cham. https://doi.org/10.1007/978-3-030-31946-5_7

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