Abstract
Spinal cord injury (SCI) often presents difficult anesthesia management problems. The goals of the perioperative management of SCI are to prevent further spinal cord damage and fatal complications. However, knowledge of the best treatment for neurological injury is limited. In the early management of acute injuries, it is most important to prevent secondary injury by spinal immobilization during transport, airway manipulation, and correct positioning. In addition to spinal immobilization, the current standard of anesthetic management includes support of adequate arterial oxygenation, blood pressure and spinal cord perfusion.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bohlman HH (1979) Acute fractures and dislocations of the cervical spine. J Bone Joint Surg Am 61:1119–1141
DeVivo MJ, Black EJ, Stover SL (1993) Causes of death during the first 12 years after spinal cord injury. Arch Phys Med Rehabil 74:248–254
DeVivo MJ, Rutt RD, Black KJ et al (1992) Trends in spinal cord injury demographics and treatment outcomes between 1973 and 1986. Arch Phys Med Rehabil 73:424–430
Ducker TB, Russo GL, Bellegarrique R et al (1979) Complete sensorimotor paralysis after cord injury: mortality, recovery and therapeutic implications. J Trauma 19:837–840
De VMJ, Richards JS, Stover SL et al (1991) Spinal cord injury—rehabilitation adds life to years. West J Med 154:602–606
Lanig IS, Lammertse DP (1992) The respiratory system in spinal cord injury. Phys Med Rehabil Clin N Am 3:725–740
Park PK, Ziring BS, Merli GJ (1993) Prophylaxis of deep venous thrombosis in patients with acute spinal cord injury. Trauma Q 9:93–99
Dooney N, Dagal A (2011) Anesthetic considerations in acute spinal cord trauma. Int J Critical Illn Inj Sci 1:36–43
Dutton RP (2002) Anesthetic management of spinal cord injury: clinical practice and future initiatives. Int Anesthesiol Clin 40:103–120
Dumont RJ, Verma S, Okonkwo DO et al (2001) Acute spinal cord injury, Part I: Pathophysiologic mechanisms. Clin Neuropharmcol 24:254–264
Fehlings MG, Sekhon LHS, Tator CH (2001) The role and timing of decompression in acute spinal cord injury. What do we know? What should we do? Spine 26(24 Suppl):101–110
Fehlings MG, Vaccaro A, Wilson JR et al (2012) Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One 7(2):e32037. doi:10.1371/journal.pone.0032037
Theodore N, Hadley MN, Aarabi B et al (2013) Prehospital cervical spine immobilization after trauma. Neurosurgery 72:22–34
Lennarson PJ, Smith DW, Sawin PD (2001) Cervical spinal motion during intubation: efficacy of stabilization maneuvers in the setting of complete segmental instability. J Neurosurg 94:265–270
McLeod ADM, Calder I (2000) Spinal cord injury and direct laryngoscopy-the legend lives on. Br J Anaesth 84:705–708
Dhall S, Hadley MN, Aarabi B et al (2013) Deep venous thrombosis and thromboembolism in patients with cervical spinal cord injuries. Neurosurgery 72:244–254
Bracken MB, Shepard MJ, Collins WF et al (1990) A randomized, control trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury. N Engl J Med 322:1405–1411
Bracken MB, Shepard MJ, Collins WF et al (1992) Methylprednisolone or naloxone treatment after acute spinal cord injury. J Neurosurg 76:23–31
Bracken MB, Shepard MJ, Holford TR et al (1997) Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. J Am Med Assoc 277:1594–1604
Bracken MB, Shepard MJ, Holford TR et al (1998) Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury. J Neurosurg 89:699–706
Hurlbert RJ, Hadley MN, Walters BC et al (2013) Pharmacological therapy for acute spinal cord injury. Neurosurgery 72:93–105
Hambly PR, Martin B (1998) Anaesthesia for chronic spinal cord lesions. Anaesthesia 53:273–289
Hickey R, Albin MS, Bunegin L et al (1986) Autoregulation of spinal cord blood flow: is the cord a microcosm of the brain? Stroke 17:1183–1189
Kobrine AI, Doyle TF, Martins AN (1975) Autoregulation of spinal cord blood flow. Clin Neurosurg 22:573–581
Marcus ML, Heistad DD, Ehrhardt J et al (1977) Regulation of total and regional spinal cord blood flow. Circ Res 41:128–134
Sekhon LHS, Fehlings MG (2001) Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine 26(24 Suppl):2–12
Ryken TC, Hurlbert RJ, Hadley MN et al (2013) The acute cardiopulmonary management of patients with cervical spinal cord injuries. Neurosurgery 72:84–92
Rosenthal MH (1999) Intraoperative fluid management–what and how much? Chest 115:106S–112S
Elgafy H, Bransford RJ, McGuire RA et al (2010) Blood loss in major spine surgery: are there effective measures to decrease massive hemorrhage in major spine fusion surgery? Spine 35:S47–S56
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Japan
About this chapter
Cite this chapter
Omi, A., Satomi, K. (2015). Anesthetic Management of Spinal Cord Injury (Unstable Cervical Spine). In: Uchino, H., Ushijima, K., Ikeda, Y. (eds) Neuroanesthesia and Cerebrospinal Protection. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54490-6_35
Download citation
DOI: https://doi.org/10.1007/978-4-431-54490-6_35
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-54489-0
Online ISBN: 978-4-431-54490-6
eBook Packages: MedicineMedicine (R0)