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State-of-the-Art Reviews: Safety in Complex Spine Surgery

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Abstract

The surgical correction of spinal deformities carries a high risk of perioperative morbidity. As the incidence of debilitating spinal deformities continues to increase, so too does our obligation to search for ways to enhance safety in our delivery of surgical care. Standardized work processes and other lean manufacturing methodologies have the potential to improve efficiency, safety, and hence value in our delivery of surgical care to patients with complex spine pathologies by reducing variability in our work processes. These principles can be applied to patient care from the initial preoperative assessment to long-term postoperative follow-up in the creation of comprehensive protocols that guide the management of these complex patients. Early evidence suggests that short-term outcomes can be improved by implementing packages of systems reform aimed at reducing variability in our work processes; however, contradicting evidence exists on the utility of several specific components of these systems-reform packages.

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Authors and Affiliations

  1. Department of Health Services Research, Neuroscience Institute, Virginia Mason Medical Center, University of Washington, Seattle, WA, USA

    Rajiv Sethi MD & Michael Bohl MD

  2. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA

    Michael Bohl MD

  3. Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA

    Michael Vitale MD

Authors
  1. Rajiv Sethi MD
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  2. Michael Bohl MD
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  3. Michael Vitale MD
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Corresponding author

Correspondence to Rajiv Sethi MD.

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Author disclosures: RS (none), MB (none), MV (personal fees from Biomet, Stryker, NuVasive, and Medtronic, outside the submitted work).

Financial Support: None

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Sethi, R., Bohl, M. & Vitale, M. State-of-the-Art Reviews: Safety in Complex Spine Surgery. Spine Deform 7, 657–668 (2019). https://doi.org/10.1016/j.jspd.2019.04.002

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  • DOI: https://doi.org/10.1016/j.jspd.2019.04.002

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