How to start an awake spine program: Protocol and illustrative cases

Review


doi: 10.1016/j.ibneur.2022.05.009.


eCollection 2022 Dec.

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Review

Romaric Waguia et al.


IBRO Neurosci Rep.


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Abstract

Surgical techniques and technology are steadily improving, thereby expanding the pool of patients amenable for spine surgery. The growing and aging population in the United States further contributes to the increase in spine surgery cases. Traditionally, spine surgery is performed under general anesthesia. However, awake spinal surgery has recently gained traction due to evidence of decreased perioperative risks, postoperative opioid consumption, and costs, specifically in lumbar spine procedures. Despite the potential for improving outcomes, awake spine surgery has received resistance and has yet to become adopted at many healthcare systems. We aim to provide the fundamental steps in facilitating the initiation of awake spine surgery programs. We also present case reports of two patients who underwent awake spine surgery and reported improved clinical outcomes.


Keywords:

Awake Spinal Fusion; Awake protocol; Awake spine cases; Awake spine surgery; ERAS; Spinal anesthesia.

Conflict of interest statement

Romaric Waguia, Elisabeth Kakmou, David Sykes, Margot Kelly-Hedrick, Hiji Fady, Norah Foster: None. Muhammad Abd-El-Barr: Consultant for Spineology, Depuy Synthes.

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