Outcome‐directed clinical practice in lumbar spine surgery

Abstract

Outcome audits describe the current level of clinical performance and direct change in clinical practice. The outcome measures used should be not only relevant and easily understood but also available to all interested parties, e.g. patients, clinicians and commissioners of health. The results of audits can be used to set the standard from which clinical practice can be monitored and improved. An expectation of likely outcome also gives the patient the opportunity of being able to make a fully informed choice. This audit using prospective data examines and compares the outcome of surgery for degenerative lumbar spine disease over a two-year period. The results allow more accurate information to be given to patients, areas of service development to be identified and changes in clinical practice to be made.

Complications in lumbar spine surgery: A retrospective analysis

“…Variety of risk factors for these complications have been identified by many authors. Patient's age, obesity, diabetes, urinary incontinence, tobacco intake, poor nutritional status, complete neurologic deficit, revision surgery, use of nonsteroidal antinflammatory drugs (NSAIDs), posterior surgical approach, increased estimated blood loss, need for blood transfusion, prolonged surgical time, multilevel surgery, fusion extended to the sacrum and use of spinal instrumentation have all been correlated to an increased risk of complications in adult spinal surgery 1011. The purpose of this study is to evaluate intraoperative and perioperative complication rates in a retrospective series of 338 patients who underwent lumbar surgical procedures and to evaluate advanced age (more than 65 years) and its correlation with occurrence of complications in lumbar spinal surgery.…”

Frequency of CSF Leak after Primary Repair of Incidental Durotomy in Lumbar Spine Surgery with use of Fibrin Glue

“…Variety of risk factors for these complications have been identified by many authors. Patient's age, obesity, diabetes, urinary incontinence, tobacco intake, poor nutritional status, complete neurologic deficit, revision surgery, use of non-steroidal antinflammatory drugs (NSAIDs), posterior surgical approach, increased estimated blood loss, need for blood transfusion, prolonged surgical time, multilevel surgery, fusion extended to the sacrum and use of spinal instrumentation have all been correlated to an increased risk of complications in adult spinal surgery 11,12 .…”

The Next Giant Leap in Spinal Surgery: Is it Nanotechnology?

“…Spinal pathologies, which do not respond to conservative management, are traditionally managed with spinal surgeries. While surgical procedures are considered to be the best solutions to spinal ailments, operative interventions alone cannot be the answer to a number of subtler pathologies involving the fine neural elements [1]. Interventions causing alterations at the cellular and subcellular levels of the neural tissues are feasible today; and nanotechnology is one such unique scientific venture which holds a potentially huge prospect in this respect.…”