Perioperative Risk Assessment and Morbidity Associated with Lumbar Spine Surgery

Balancing the risks and benefits of spine surgery is important to securing a successful outcome. The goals of perioperative medical risk assessment are to optimize the patient's medical condition preoperatively and minimize the potential for postoperative morbidity and mortality. Common sources of morbidity and mortality in spine surgery that benefit from perioperative optimization include cardiac, respiratory, and renal conditions. Patients with diabetes, malnutrition, and obesity warrant special consideration. An informed dialogue establishing realistic expectations, potential pitfalls, and alternatives is equally important. The elements of successful perioperative management of the patient who is being considered for spine surgery are reviewed here.