Preoperative Risk Stratification: Who Needs Medical Consultation?

Abstract

Study Design.Spine update.Objective.The purpose of this study is to provide a review of preoperative clearance and optimization, before elective spine surgery.Summary of Background Data.Patient optimization preceding elective surgery is critical to ensure the best possible outcome.Methods.Historical and current literature pertaining to patient clearance and optimization, before elective surgery, was reviewed. These data were then synthesized and assessed to provide a balanced view on current trends in regards to preoperative management and optimization.Results.The American Academy of Cardiology defines spine surgery as "intermediate" risk, and thus patients are permitted to forgo formal cardiac evaluation if they have no active cardiac condition and demonstrate adequate functional capacity; however, those with active or chronic medical conditions require further investigation before elective operations.Conclusion.Overall, preoperative screening and optimization of comorbidities are vital to ensure positive outcomes in elective spine surgery, and the aforementioned criteria must be considered on an individual basis. Further research into specific preoperative optimization guidelines would help to ensure successful outcomes for those undergoing spine surgery.Level of Evidence: N/A.