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Comprehensive Spine Surgery Protocol Guide

Evidence-based Guidelines for Pre-operative, Intra-operative, and Post-operative Care

Orthopedics

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Last updated: Mar 24, 2025

Pre-operative Phase

Patient Assessment

  • Complete medical history review
  • Physical examination
  • Imaging studies (MRI, CT, X-rays)
  • Pre-operative lab work
  • Anesthesia evaluation

Pre-operative Planning

  1. Surgical Approach Selection

    • Anterior vs. posterior
    • Minimally invasive vs. open
    • Level-specific considerations

  2. Equipment Preparation

    • Implant selection
    • Instrument verification
    • Imaging equipment setup

Intra-operative Phase

Patient Positioning

  • Prone/supine positioning protocol
  • Pressure point protection
  • Neurophysiological monitoring setup

Surgical Protocol

  1. Approach

    • Skin preparation and draping
    • Incision planning
    • Soft tissue handling

  2. Procedure Steps

    • Decompression
    • Fusion technique
    • Hardware placement
    • Wound closure

Monitoring

  • Neuromonitoring parameters
  • Hemodynamic stability
  • Blood loss management

Post-operative Phase

Immediate Post-op Care

  1. Pain management protocol
  2. Neurological monitoring
  3. Wound care guidelines
  4. Mobilization timeline

Discharge Planning

  • Physical therapy protocol
  • Follow-up schedule
  • Patient education

Complications Management

Early Recognition

  • Neurological deficits
  • Infection signs
  • Hardware issues

Management Protocols

  • Emergency response procedures
  • Revision surgery criteria
  • Documentation requirements

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