Preoperative Optimization: Risk Factors for Perioperative Complications and Preoperative Modification

Kosei Nagata; John R Dimar 2nd; Leah Y Carreon; Steven D Glassman

doi:10.1016/j.nec.2023.06.015

Preoperative Optimization: Risk Factors for Perioperative Complications and Preoperative Modification

Neurosurg Clin N Am. 2023 Oct;34(4):505-517. doi: 10.1016/j.nec.2023.06.015. Epub 2023 Aug 7.

Authors

Kosei Nagata¹, John R Dimar 2nd¹, Leah Y Carreon², Steven D Glassman¹

Affiliations

¹ Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA.
² Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA. Electronic address: leah.carreon@nortonhealthcare.org.

PMID: 37718097
DOI: 10.1016/j.nec.2023.06.015

Abstract

Adult spinal deformity (ASD) is common and the complication rate in ASD surgery is high due to its invasiveness. There are several factors that increase the risk of complications with ASD surgery. These include age, past medical history, frailty, osteoporosis, or operative invasiveness. Risk factors for perioperative complications can be categorized as modifiable and non-modifiable. The purpose of this article is to present the current available evidence on risk factors for perioperative complications, with a focus on frailty, osteoporosis, surgical site infection prevention, and hip-spine syndrome. In addition, we present the latest evidence for patient-specific surgical risk assessment and surgical planning.

Keywords: Adult spinal deformity; Complications; Frailty; Hip-spine syndrome; Osteoporosis; Planning; Surgical site infection.

Publication types

Review

MeSH terms

Adult
Frailty*
Humans
Neurosurgical Procedures
Osteoporosis*
Risk Assessment
Risk Factors