ABNS POST® - Practice and Outcomes of Surgical Therapies

1. Register for ABNS POST® access.
2. Business Associate Agreement: review and sign.
3. Enter information about clinical practice, such as type, setting, description, region, sub-specialty and site(s) of service.
4. Click "Finish Setup"

• Case Title: include brief description of procedure and diagnosis
• Case Overview
• Medical History: pertinent positives or negatives that are essential to understanding clinical decision-making
• Medications
• Physical Exam: pertinent positives or negatives that are essential to understanding clinical decision-making and justify the clinical outcome for this case to a clinical colleague.
• Imaging and Testing: Include up to fifteen (15) images: pre-and post-operative, intraoperative where relevant. Include imaging of all spine levels treated. Imaging cannot exceed 800kb.
• Non-surgical Management
• Diagnoses
• Surgical Management
• Pathology Results: enter results of any specimens or biopsies sent to pathology
• CPT coding
• Surgical Outcomes: Objectives of surgery, immediate outcomes (during hospital stay), intermediate outcomes (discharge to three months) and late outcomes (3-12 months)

• When entering cases, you must provide the necessary information for another neurosurgeon to understand the diagnosis, indications for surgery, operation performed, complications (if any), post-operative management, and outcomes. If your cases lack appropriate details, you may receive multiple queries and/or be asked for a systemic dataset revision.
• Case Title: The title should be brief but have relevant details. It should give the reviewer a description of the operation and diagnosis. Here are examples:
  • Right frontal craniotomy for resection of metastasis instead of "crani"
  • T5-7 laminectomies with resection of posterior epidural metastasis causing spinal cord compression instead of "met"
  • C3-5 laminectomies and instrumented fusion with resection of intradural schwannoma instead of "neck tumor"
  • Right L5-S1 microdiscectomy for right S1 radiculopathy instead of "L5-S1 disc"
• Provide enough history and neurological exam findings for the examiner to understand the indication/rationale for surgery. A straightforward operation (i.e. burr hole for chronic SDH) may require very little description, while cases like long segment decompression and fusions or craniotomies for extensive tumors, aneurysms, AVMs require more description.
• Provide enough imaging for the reviewer to understand your surgical approach. The reviewer will send you a query if imaging is inadequate and there is uncertaintly about the indication for the procedure you performed
• Complications, management, and outcome: If the patient has a complication, you must explain your management of the complication. In the follow-up/outcomes section, you should explicitly state the post-operative status of the patient’s pre-operative symptoms and neurological deficits. Avoid vague statements like “patient improved and happy with result." You may be asked for a systemic dataset revision if many of your cases lack the appropriate follow-up information.
• The uploaded images must match the text and be from the same patient. Be sure to review each case and make sure the correct images are uploaded to the correct patient.

Requirements and guidelines for the case log submission are as follows:

• 125 consecutive cases
• All cases must have been performed over a period of 18 months or less.
• All cases must have 3 months follow up.
• Follow up may be performed outside the 18-month window.
• "Staged procedures" will count towards the total of 125.
• Complication management/revision (“take back” surgery) is considered an extension of the original operation, and will not be counted towards the 125 total.
• Clinical data must be from at least 100 unique patient encounters.
• No case can be older than 24 months at the date of submission.
• Cases during residency or fellowships cannot be included.
• Any case where the candidate is the neurosurgical decision maker should be included in the case log. This means primary surgeon or co-surgeon who will diagnosis, manage and bill for the neurological procedures performed. If a candidate simply assists another neurosurgeon in the OR on a case, that case should not be included.
• Enter all CPT codes from the procedure that were billed with you as the provider.
• Diagnostic angiograms as a stand-alone case should not be entered into POST. They may be included as part of the workflow of a case.
• External ventricular drains, battery changes, spinal cord stimulator lead removals and other minor procedures should not be included in the POST log.
• Upload preoperative imaging that supports your decision-making and postoperative imaging showing your procedure/outcome. For spine, include axial and sagittal preoperative views for levels treated. Postoperative images must include ap/lateral of the construct. EOS films are not acceptable for postoperative evaluation.

If tracking for ABPNS/ABNS dual credential, 95 of the 125 must be cases performed on patients 21 years or younger.

• If after logging the required 125 consecutive cases, there are not 95 PEDS cases add ONLY the necessary number of PEDS cases to reach the requirement of 95 or reach out to discuss alternative submission.

*** Of note: The total number of submitted surgical procedures may exceed 125 due to "take back" surgeries