ABSTRACT
Revision surgical procedures are challenging undertakings for both surgeons and patients alike. Multiple host and surgical issues often complicate revision spine procedures, including impaired biology secondary to the primary surgical procedure. A crucial element of history-taking in the postsurgical patient population is the mental health evaluation. After completion of a thorough history and physical examination, imaging studies are generally warranted to evaluate for pseudarthrosis or new pathology. Prior to revision spine surgery, laboratory evaluation needs to focus on reversible causes of pseudarthrosis and other conditions that can lead to surgical failure. Laboratory evaluation can demonstrate an elevated white blood count, with a shift toward polymorphonuclear cells, erythrocyte sedimentation rate, or C-reactive protein levels. Treatment of surgical site infections generally involves early recognition, copious irrigation, debridement of infected and necrotic tissues, and culture-directed intravenous antibiotic therapy. When psychological factors are suspected, multimodal treatment programs that include psychological pain management therapy should be considered prior to surgical intervention.
