NASS Clinical Practice 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.
The NASS Evidence-Based Guidelines for Multidisciplinary Spine Care currently available include:
- Degenerative Lumbar Spinal Stenosis FREE DOWNLOAD
Provides evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of degenerative lumbar spinal stenosis. The guideline is intended to reflect contemporary treatment concepts for symptomatic degenerative lumbar spinal stenosis as reflected in the highest quality clinical literature available on this subject as of April 2006. 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 FREE DOWNLOAD
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.
COMING SOON!
The Evidence-based Guideline Development Committee is currently writing a guideline addressing diagnosis and treatment of degenerative lumbar spondylolisthesis. It is anticipated that this guideline will be available by spring 2008.
Prior to implementing an evidence-based methodology, guidelines were based on a review of the literature, supplemented by expert consensus. The NASS Clinical Guidelines for Multidisciplinary Spine Care Specialists published between 2000 and 2002 will remain available until they are updated implementing an evidence-based methodology. These guidelines address primary to chronic, multidisciplinary treatment, incorporating principles of acute and postacute care. Issues such as specific time frames for treatment, coordination of definitions of common practice terms, definition of end points for treatment and treatment success or failure are examples of areas covered.
Guidelines are currently available for the diagnoses of:
- Herniated Disc
- Spondylolysis, Lytic and Degenerative Spondylolisthesis
- Unremitting Low Back Pain
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NASS Clinical Guidelines for Multidisciplinary Spine Care Specialists
NASS members: $60 for the complete set or $25 for each specific guideline.
Nonmembers: $75 for the complete set or $30 per guideline.
For more information, please contact NASS toll-free at (866) 960-6277.
For questions about NASS guideline projects, please contact the Research Department.
Spine Guidelines by Other Organizations
In addition to developing clinical practice guidelines, NASS also reviews guidelines and clinical recommendations developed by other organizations, sometimes providing an endorsement. In keeping with NASS’ Policy on the Endorsement of Clinical Guidelines, when a NASS endorsement is provided, it does not constitute support or criticism of the content, but rather endorsement of the process by which the guideline was developed. Although NASS does not endorse the content of any guidelines, NASS will include links to statements which may be of interest to NASS members.
NASS has reviewed the following guidelines and is providing a link for those who wish to review the information or contact the developing organization.
Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery
(Approved by the ASA House of Delegates on October 25, 2005)
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). The advisory is available on the ASA web site here.
Guidelines for the Performance of Lumbar Fusion for Degenerative Disease of the Lumbar Spine
(Published in Journal of Neurosurgery: Spine, Volume 2, June 2005)
The American Association of Neurological Surgeons and Congress of Neurological Surgeons recently issued these guidelines. Sections of the guidelines address the following:
- assessment of outcomes following lumbar fusion;
- the diagnostic modalities helpful for the pre- and postoperative evaluation of patients considered candidates for or treated with lumbar fusion;
- recommendations for specific patient populations;
- surgical adjuncts (including pedicle screws, intraoperative monitoring and bone graft substitutes).
The guidelines are available via the AANS/CNS Spine Section Web site
here.