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Team Approach: Safety and Value in the Practice of Complex Adult Spinal Surgery.
Rajiv K Sethi1,2, Anna K Wright1, Venu M Nemani1
1Neuroscience Institute (R.K.S., A.K.W., V.M.N., and J.-C.A.L.), and the Departments of Anesthesiology (H.A.B.) and Physical Medicine and Rehabilitation (A.S.F.), Virginia Mason Medical Center, Seattle, Washington.
Optimizing risk factors can reduce the significant risks associated with complex adult spinal deformity surgery. A multidisciplinary team approach ensures comprehensive preoperative evaluation and perioperative care for better patient outcomes.
Area of Science:
- Spine surgery
- Orthopaedic surgery
- Neurosurgery
Background:
- Complex adult spinal deformities carry high surgical risks, including operative mortality.
- Risk-factor optimization is crucial for minimizing potential morbidity.
- Multidisciplinary team care models enhance patient management.
Observation:
- A 66-year-old male with prior spinal cord injury presented with Charcot spinal arthropathy.
- Progressive vertebral body destruction led to lumbar kyphosis.
- This case illustrates the application of a multidisciplinary care model.
Findings:
- Integrated care pathways provide structured preoperative evaluation.
- Evidence-based multimodal perioperative care is essential.
- Team members include neurosurgeons, orthopaedic surgeons, physiatrists, and more.
Implications:
- Multidisciplinary care can improve outcomes for high-risk spinal surgery patients.
- Structured care pathways are key to managing complex spinal deformities.
- Risk optimization is paramount in adult spinal deformity surgery.
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