"Spine Surgery Checklist": A Step towards Perfection through Protocols.

Area of Science:

• Neurosurgery
• Surgical Safety
• Patient Outcomes

Background:

• Spine surgery carries inherent risks of preventable human errors and perioperative complications.
• A unique checklist designed for spine surgery aims to mitigate these risks by recognizing risk factors and anticipating potential errors.
• The checklist is intended to enhance patient safety, improve communication, reduce surgical claims, and decrease postoperative complications.

Purpose of the Study:

• To evaluate the effectiveness of a novel, spine surgery-specific checklist.
• To determine if the checklist reduces common preventable human errors and major perioperative complications in spine surgery.

Main Methods:

• A retrospective pilot study conducted at a single center.
• 858 spine surgery patients were divided into two groups: a control group (2015-2016, before checklist) and a study group (2016-2017, after checklist implementation).
• Incidence of preventable errors and major perioperative complications were recorded and compared between the groups.

Main Results:

• The overall prevalence of preventable errors was 1.63%, with wrong-level surgeries at 0%.
• The checklist implementation was associated with a significant reduction in preventable errors related to complications such as infections, prolonged hospital stays, and unplanned readmissions/revision surgeries (p=0.001).
• Rates of adverse events, near-misses, and no-harm events were low, and the reoperation rate related to preventable errors decreased.

Conclusions:

• The developed spine surgery-specific checklist is comprehensive, covering perioperative parameters.
• The checklist is effective, safe, and easy to use for reducing critical errors and perioperative complications in spine surgery.
• Further validation through large, multi-center, randomized controlled studies is recommended for broader implementation.