Clinical Guidelines

NASS clinical guidelines offer evidence-based recommendations addressing key clinical questions for specific diagnoses.

NASS Guidelines

NASS develops clinical practice guidelines regarding the diagnosis and treatment of spinal disorders. Guidelines are intended as educational tools for a multidisciplinary audience to improve patient care by outlining reasonable information-gathering and decision-making processes used in the management of back pain in adults. The NASS Clinical Practice Guideline Committee is trained in evidence analysis and uses an evidence-based guideline development methodology.

Currently Under Development

Diagnosis and Treatment of Neoplastic Vertebral Fractures in Adults IN PROGRESS

Diagnosis and Treatment of Osteoporotic Vertebral Compression Fractures in Adults IN PROGRESS

Antithrombotic Therapies in Spine Surgery (Revision) IN PROGRESS

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Diagnosis and Treatment of Low Back Pain (2020) NEW
Endorsed by the American Academy of Physical Medicine and Rehabilitation (AAPM&R) and American Association of Neurological Surgeons and Congress of Neurological Surgeons (AANS/CNS). Last updated 8/10/2020.

Diagnosis and Treatment of Adult Isthmic Spondylolisthesis (2014)

Diagnosis and Treatment of Degenerative Spondylolisthesis (Revised 2014)

Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy (2012)

Antibiotic Prophylaxis in Spine Surgery (Revised 2013)

Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis (Revised 2011)

Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders (2010)

Antithrombotic Therapies in Spine Surgery (2009)


NASS encourages widespread circulation and implementation of the evidence-based recommendations made in NASS guidelines. To this end, NASS supports responsible translation of its clinical practice guidelines into other languages. NASS strongly encourages use of appropriately trained translators with an excellent knowledge of the English language, an excellent knowledge of the target language, significant experience in both languages, cultures and medicine, and ideally some content knowledge.

It is also strongly recommended that translators implement a rigorous procedure for verifying the accuracy of translations via a multiple forward translation process or a back-translation process with careful comparisons between documents. Individuals interested in translating guidelines are granted permission to do so, provided the resulting publication follows these requirements:

  • The document carries the NASS disclaimers below
  • The document clearly indicates the version of the guideline being translated either by version number or date of publication by NASS
  • No fees are charged above those charges necessary to recoup the cost of translation.

Any translations of the NASS clinical practice guidelines should carry the following disclaimers on each page:

Translation Disclaimer:

Reprinted and translated with the permission of NASS. NASS does not verify, certify and is not responsible for the accuracy of any translations, and has advised any parties translating the NASS clinical practice guidelines to carefully verify the accuracy of their translations prior to publication and dissemination.

Clinical Guideline Disclaimer:

This clinical guideline should not be construed as including all proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment is to be made by the physician and patient in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution.

Any prospective translator must complete the clinical practice guideline translation record and send a copy to NASS to keep on file so that NASS may track translations, appropriately direct individuals to translations of interest and notify translators of content updates and revisions.