The need for clinical practice guidelines in assessing and managing perioperative neurologic deficit: results from a survey of the AOSpine international community

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dc.contributor.author Nater, A.
dc.contributor.author Murray, J. C.
dc.contributor.author Martin, A. R.
dc.contributor.author Nouri, A.
dc.contributor.author Tetreault, Lindsay A.
dc.contributor.author Fehlings, Michael G.
dc.date.accessioned 2017-06-21T15:08:40Z
dc.date.available 2017-06-21T15:08:40Z
dc.date.issued 2017-06-16
dc.identifier.citation Nater, A., Murray, J. C., Martin, A. R., Nouri, A., Tetreault, L. and Fehlings, M. G. 'The Need for Clinical Practice Guidelines in Assessing and Managing Perioperative Neurologic Deficit: Results from a Survey of the AOSpine International Community', World Neurosurgery. In Press, doi:10.1016/j.wneu.2017.06.029 en
dc.identifier.issn 1878-8750
dc.identifier.uri http://hdl.handle.net/10468/4144
dc.identifier.doi 10.1016/j.wneu.2017.06.029
dc.description.abstract Objectives: There is no standardized approach to assess and manage perioperative neurologic deficit (PND) in patients undergoing spinal surgery. This survey aimed to evaluate the awareness and usage of clinical practice guidelines (CPGs) as well as investigate how surgeons performing spine surgeries feel about and manage PND, and how they perceive the value of developing CPGs for the management of PND. Methods: An invitation to participate was sent to the AOSpine International community. Questions were related to the awareness, usage of CPGs and demographics. Results from the entire sample and subgroups were analyzed. Results: Of 770 respondents, 659 (85.6%) reported being aware of the existence of guideline(s), and among those, 578 (87.7%) acknowledged using guideline(s). Overall, 58.8% of surgeons reported not feeling comfortable managing a patient who wakes up quadriplegic after an uneventful multilevel posterior cervical decompression with instrumented fusion. While 22.9% would consider an immediate return to the operating room, the other 77.1% favored conducting some kind of investigation/medical intervention first, such as obtaining a MRI (85.9%), administrating high-dose corticosteroids (50.2%) or increasing the MAP (44.7%). Overall, 90.6% of surgeons believed that CPGs for the management of PND would be useful and 94.4% would be either likely or extremely likely to use these CPGs in their clinical practice. Conclusions: The majority of respondents are aware and routinely use CPGs in their practice. Most surgeons performing spine surgeries reported not feeling comfortable managing PND. However, they highly value the creation and are likely to use CPGs in its management. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier en
dc.rights © 2017 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Attitude en
dc.subject Perspective en
dc.subject Clinical practice guideline en
dc.subject Perioperative neurologic deficit en
dc.subject Spinal surgery en
dc.subject Survey en
dc.title The need for clinical practice guidelines in assessing and managing perioperative neurologic deficit: results from a survey of the AOSpine international community en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Lindsay A. Tetreault, Medicine, University College Cork, +353 21 490 3000 en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication at the request of the publisher. en
dc.check.date 2018-06-16
dc.description.version Accepted Version en
dc.contributor.funder AO Foundation en
dc.contributor.funder AOSpine en
dc.description.status Peer reviewed en
dc.identifier.journaltitle World Neurosurgery en


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© 2017 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license Except where otherwise noted, this item's license is described as © 2017 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
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