Treatment Algorithms and Protocol Practice in High-Risk Spine Surgery

The practice of appropriate evidence-based medicine should be a goal for all physicians. By using protocols in areas where strong evidence-based medicine exists, physicians have reliably shown they can improve patient outcomes while reducing complications, cost, and hospital stay. Evidence-based protocols in complex spinal care are rare. At Northwestern University the authors have developed a multidisciplinary protocol for the preoperative, intraoperative, and postoperative workup and care of complex spine patients. The rationale and use of the High-Risk Spine Protocol is discussed.