• Samuel N Blacker, Nathan Woody, Abate ShiferawAnanyaADepartment of Anesthesiology, Tikur Anbessa Specialized Hospital., Mark Burbridge, Maria A Bustillo, Sprague W Hazard, Benjamin J Heller, Massimo Lamperti, Jorge Mejia-Mantilla, Jacob W Nadler, Girija Prasad Rath, Chiara Robba, Anita Vincent, Azarias K Admasu, Meron Awraris, and Abhijit V Lele.
• Department of Anesthesiology, University of North Carolina, Chapel Hill, NC.
• J Neurosurg Anesthesiol. 2024 Jul 1; 36 (3): 218227218-227.

BackgroundThe aim of this survey was to understand institutional spine surgery practices and their concordance with published best practices/recommendations.MethodsUsing a global internet-based survey examining perioperative spine surgery practice, reported institutional spine pathway elements (n=139) were compared with the level of evidence published in guideline recommendations. The concordance of clinical practice with guidelines was categorized as poor (≤20%), fair (21%-40%), moderate (41%-60%), good (61%-80%), or very good (81%-100%).ResultsSeventy-two of 409 (17.6%) institutional contacts started the survey, of which 31 (7.6%) completed the survey. Six (19.4%) of the completed surveys were from respondents in low/middle-income countries, and 25 (80.6%) were from respondents in high-income countries. Forty-one incomplete surveys were not included in the final analysis, as most were less than 40% complete. Five of 139 (3.6%) reported elements had very good concordance for the entire cohort; hospitals with spine surgery pathways reported 18 elements with very good concordance, whereas institutions without spine surgery pathways reported only 1 element with very good concordance. Reported spine pathways included between 7 and 47 separate pathway elements. There were 87 unique elements in the reviewed pathways. Only 3 of 87 (3.4%) elements with high-quality evidence demonstrated very good practice concordance.ConclusionsThis global survey-based study identified practice variation and low adoption rates of high-quality evidence in the care of patients undergoing complex spine surgery.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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