OrthoNeuroSpine & Pain Institute

Standards provide rules or minimum requirements for clinical practice. They are regarded as generally accepted principles of patient management. Standards may be modified only under unusual circumstances, e.g., extreme emergencies or unavailability of equipment.

Guidelines are systematically developed recommendations that assist the practitioner and patient in making decisions about health care. These recommendations may be adopted, modified, or rejected according to clinical needs and constraints and are not intended to replace local institutional policies. In addition, practice guidelines are not intended as standards or absolute requirements, and their use cannot guarantee any specific outcome. Practice guidelines are subject to revision as warranted by the evolution of medical knowledge, technology, and practice. They provide basic recommendations that are supported by a synthesis and analysis of the current literature, expert opinion, open forum commentary, and clinical feasibility data.

Statements represent the opinions, beliefs, and best medical judgments of the House of Delegates. As such, they are not necessarily subjected to the same level of formal scientific review as ASA Standards or Guidelines. Each ASA member, institution or practice should decide individually whether to implement some, none, or all of the principles in ASA statements based on the sound medical judgment of anesthesiologists participating in that institution or practice.

NASS GUIDELINES

NASS continues development of clinical practice guidelines related to the diagnosis and treatment of spinal disorders. Guidelines are developed as educational tools for multidisciplinary spine care professionals to improve patient care by outlining reasonable information-gathering and decision-making processes used in the management of back pain in adults.

NASS has committed substantial resources to training the NASS Evidence-based Guideline Development Committee in evidence analysis, using both face-to-face and online training, and has recently begun implementing an evidence-based guideline development methodology.

Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders

Provides evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of cervical radiculopathy. The guideline is intended to reflect contemporary treatment concepts for cervical radiculopathy as reflected in the highest quality clinical literature available on this subject as of May 2009. The goals of the guideline recommendations are to assist in delivering optimum, efficacious treatment and functional recovery from this spinal disorder.

Antithrombotic Therapies in Spine Surgery

Provides evidence-based recommendations to address key clinical questions surrounding the use of antithrombotic therapies in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of February 2008. The goals of the guideline recommendations are to assist in delivering optimum, efficacious treatment with the goal of preventing thromboembolic events.

Diagnosis and Treatment of Degenerative Spondylolisthesis

Provides evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of degenerative lumbar spondylolisthesis. The guideline is intended to reflect contemporary treatment concepts for symptomatic degenerative lumbar spondylolisthesis as reflected in the highest quality clinical literature available on this subject as of June 2007. The goals of the guideline recommendations are to assist in delivering optimum, efficacious treatment and functional recovery from this spinal disorder.

Antibiotic Prophylaxis in Spine Surgery

Provides evidence-based recommendations on key clinical questions concerning the use of prophylactic antibiotics in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of December 2006. The goal of the guideline recommendations are to assist in delivering optimum, efficacious treatment in regards to preventing surgical site infection.

Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery

Developed by the American Society of Anesthesiologists (ASA) Task Force on Perioperative Blindness, the purposes of this advisory are to enhance awareness of permanent impairment or total loss of sight associated with a spine procedure during which general anesthesia is administered and to reduce its frequency. The conditions addressed in this advisory are posterior ischemic optic neuropathy (PION), anterior ischemic optic neuropathy (AION) and central retinal artery occlusion (CRAO).