Comprehensive guidelines for prehabilitation in spine surgery

Study Design: Literature review. Objectives: Review prehabilitation techniques used for elective spine surgery to create a comprehensive list of recommendations. Methods: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines by sear...

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Main Authors: Paulomi Gohel, Raj Swaroop Lavadi, Mohamed-Ali H. Jawad-Makki, Rohit Prem Kumar, Ayesha Akbar Waheed, Lior M. Elkaim, Vinay Jaikumar, Nima Alan, Thomas J. Buell, Brenton Pennicooke, D. Kojo Hamilton, Nitin Agarwal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Craniovertebral Junction and Spine
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Online Access:https://journals.lww.com/10.4103/jcvjs.jcvjs_209_24
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author Paulomi Gohel
Raj Swaroop Lavadi
Mohamed-Ali H. Jawad-Makki
Rohit Prem Kumar
Ayesha Akbar Waheed
Lior M. Elkaim
Vinay Jaikumar
Nima Alan
Thomas J. Buell
Brenton Pennicooke
D. Kojo Hamilton
Nitin Agarwal
author_facet Paulomi Gohel
Raj Swaroop Lavadi
Mohamed-Ali H. Jawad-Makki
Rohit Prem Kumar
Ayesha Akbar Waheed
Lior M. Elkaim
Vinay Jaikumar
Nima Alan
Thomas J. Buell
Brenton Pennicooke
D. Kojo Hamilton
Nitin Agarwal
author_sort Paulomi Gohel
collection DOAJ
description Study Design: Literature review. Objectives: Review prehabilitation techniques used for elective spine surgery to create a comprehensive list of recommendations. Methods: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines by searching three electronic databases from 1997 to 2021. Pertinent literature reporting information on prehabilitation, applicable to spine surgery, was identified. Seventy studies were selected for further analysis. Findings from the literature were reinforced by practices employed by the authors. Results: Preoperative smoking cessation should be achieved 3–4 weeks before elective spine surgery. Preoperative weight loss programs to reach a goal BMI <35 kg/m2 may be a viable solution to minimize wound complications and surgical site infections. To minimize the negative impact of cardiopulmonary comorbidities, patients can enroll in an exercise program prior to surgery. Patients should abstain from alcohol before elective spine surgery. Patients with osteoporosis may benefit from supplementation with Vitamin D, calcium, and parathyroid hormone. Opioids should be weaned to complete cessation 6–8 weeks before surgery. Preoperative cognitive behavioral therapy (CBT) and education seem to be the most beneficial in reducing complications associated with psychiatric comorbidities. Patients should engage in a comprehensive prehabilitation regimen. Conclusion: Targeting patient risk factors with personalized interventions can improve postoperative outcomes in patients undergoing elective spine surgery.
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spelling doaj-art-1fc408825fee496c9fe50b6efcedf3a02025-08-20T03:24:43ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852025-01-0116151510.4103/jcvjs.jcvjs_209_24Comprehensive guidelines for prehabilitation in spine surgeryPaulomi GohelRaj Swaroop LavadiMohamed-Ali H. Jawad-MakkiRohit Prem KumarAyesha Akbar WaheedLior M. ElkaimVinay JaikumarNima AlanThomas J. BuellBrenton PennicookeD. Kojo HamiltonNitin AgarwalStudy Design: Literature review. Objectives: Review prehabilitation techniques used for elective spine surgery to create a comprehensive list of recommendations. Methods: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines by searching three electronic databases from 1997 to 2021. Pertinent literature reporting information on prehabilitation, applicable to spine surgery, was identified. Seventy studies were selected for further analysis. Findings from the literature were reinforced by practices employed by the authors. Results: Preoperative smoking cessation should be achieved 3–4 weeks before elective spine surgery. Preoperative weight loss programs to reach a goal BMI <35 kg/m2 may be a viable solution to minimize wound complications and surgical site infections. To minimize the negative impact of cardiopulmonary comorbidities, patients can enroll in an exercise program prior to surgery. Patients should abstain from alcohol before elective spine surgery. Patients with osteoporosis may benefit from supplementation with Vitamin D, calcium, and parathyroid hormone. Opioids should be weaned to complete cessation 6–8 weeks before surgery. Preoperative cognitive behavioral therapy (CBT) and education seem to be the most beneficial in reducing complications associated with psychiatric comorbidities. Patients should engage in a comprehensive prehabilitation regimen. Conclusion: Targeting patient risk factors with personalized interventions can improve postoperative outcomes in patients undergoing elective spine surgery.https://journals.lww.com/10.4103/jcvjs.jcvjs_209_24elective spine surgerypostoperative complicationsprehabilitationpreoperative risk
spellingShingle Paulomi Gohel
Raj Swaroop Lavadi
Mohamed-Ali H. Jawad-Makki
Rohit Prem Kumar
Ayesha Akbar Waheed
Lior M. Elkaim
Vinay Jaikumar
Nima Alan
Thomas J. Buell
Brenton Pennicooke
D. Kojo Hamilton
Nitin Agarwal
Comprehensive guidelines for prehabilitation in spine surgery
Journal of Craniovertebral Junction and Spine
elective spine surgery
postoperative complications
prehabilitation
preoperative risk
title Comprehensive guidelines for prehabilitation in spine surgery
title_full Comprehensive guidelines for prehabilitation in spine surgery
title_fullStr Comprehensive guidelines for prehabilitation in spine surgery
title_full_unstemmed Comprehensive guidelines for prehabilitation in spine surgery
title_short Comprehensive guidelines for prehabilitation in spine surgery
title_sort comprehensive guidelines for prehabilitation in spine surgery
topic elective spine surgery
postoperative complications
prehabilitation
preoperative risk
url https://journals.lww.com/10.4103/jcvjs.jcvjs_209_24
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