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规范择期脊柱手术的术前护理:俄克拉荷马大学择期脊柱手术方案

Standardizing Preoperative Care for Elective Spine Surgery: The University of Oklahoma Elective Spine Surgery Protocol.

作者信息

Smith Lonnie, Barkyoumb David, Kaiser William C, Muhammad Fauziyya, Sukut Tara, Purani Ishan, Li Chao, Balsara Karl, Shakir Hakeem J, Janjua M Burhan, Burke John F, Jea Andrew, Smith Zachary A

机构信息

Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Vanderbilt University, Nashville, TN, USA.

出版信息

Geroscience. 2025 Sep 26. doi: 10.1007/s11357-025-01908-y.

Abstract

As rates of spinal surgery in the United States continue to rise, the field has undergone a paradigm shift towards standardized, evidence-based care aimed at optimizing surgical outcomes. Indeed, numerous Enhanced Recovery After Surgery (ERAS) protocols have emerged and demonstrated significant success in improving outcomes in spinal surgery. In this article, we present a preoperative optimization protocol for elective spinal surgery from our own institution, which is in a state with notoriously high rates of comorbidities relative to the rest of the nation. This standardized protocol addresses six critical aspects of patient care: preoperative evaluation, bone health, diabetes, nutritional status, social risk factors, and medical comorbidities. By targeting these pillars of preoperative evaluation and management in an evidence-based, standardized manner, our protocol aims to enhance patient safety, minimize complications, and optimize the overall quality of care for our elective spinal surgery patients. In doing so, this protocol meets the growing demand for improved patient care in the expanding field of spinal surgery and lays the foundation for future advancements in elective spine protocols, thus contributing to the ongoing pursuit of optimized surgical outcomes and overall quality of care in the field.

摘要

随着美国脊柱手术的发生率持续上升,该领域已发生范式转变,朝着旨在优化手术效果的标准化、循证医疗发展。事实上,众多术后加速康复(ERAS)方案已经出现,并在改善脊柱手术效果方面取得了显著成功。在本文中,我们展示了来自我们自己机构的择期脊柱手术术前优化方案,我们所在的州相对于美国其他地区而言,合并症发生率极高。这个标准化方案涵盖了患者护理的六个关键方面:术前评估、骨骼健康、糖尿病、营养状况、社会风险因素和内科合并症。通过以循证、标准化的方式针对术前评估和管理的这些支柱,我们的方案旨在提高患者安全性、将并发症降至最低,并优化我们择期脊柱手术患者的整体护理质量。这样做,该方案满足了脊柱手术不断扩展领域中对改善患者护理日益增长的需求,并为择期脊柱方案的未来进展奠定了基础,从而有助于在该领域持续追求优化的手术效果和整体护理质量。

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