Spinal Fusion Techniques - E-Book by Abd-Elsayed Alaa;

Author:Abd-Elsayed, Alaa; [Abd-Elsayed Alaa]
Language: eng
Format: epub
Publisher: Elsevier
Published: 2023-03-15T00:00:00+00:00

Preoperative care

Assessment of clinical indication

First, the clinician should confirm that the patient has an appropriate clinical indication to benefit from a percutaneous fusion procedure. For example, if the patient is offered a percutaneous facet joint fusion procedure, the patient should have one of the following diagnoses: facet joint dysfunction and pain, spinal instability from prior spine surgeries, microinstability of certain spinal segments, or requirement for adjunctive therapy or bridging therapy to an interbody fusion surgery. Clinical indications for other percutaneous fusion procedures are presented elsewhere within this atlas. A thorough assessment of contraindications that would preclude the proceduralist from offering this therapy to the patient should be reviewed, including coagulopathy, current infection, malignancy, and other contraindications.

Another essential component in the preoperative period is for the patient to have an “education” visit, where all questions relevant to the surgery are addressed. In many centers with specialized pain practices, this is often conducted by a nurse or an advanced nurse practitioner. This visit presents an opportunity for the patient to visualize the type of device that would be implanted, discuss alternative or adjunctive treatment, potentially meet with the device company representative, and address any pending questions before the surgery.

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