This clinical guideline was created to improve patient care by outlining the appropriate information gathering and decision-making processes involved in the treatment of patients with perioperative spinal disease. One objective of this review is to determine preoperative diagnostic studies that predict increased risk of reoperation or SSI in patients with diabetes. In addition, the published literature was assessed to determine if an increased BMI correlates with an increased risk of reoperation or SSI. Finally, the impact of preoperative smoking and risk of reoperation after spinal fusion was evaluated and if smoking cessation decreases risk.

J. Bradley Elder, MD

James S. Harrop, MD, MSHQS

Daniel J. Hoh, MD