Intensive Care Management of Traumatic Spine Injury

  • Onat Akyol
  • Cesar Reis
  • Vadim Gospodarev
  • Haley Reis
  • Shen Cheng
  • John Zhang
  • Richard L. ApplegateIIEmail author


Acute spinal cord injury (SCI) causes neurological dysfunction and interrupts normal physiological regulatory patterns and requires anesthesia and neurocritical care management. Depending on the level of injury, airway stabilization can prove challenging, and maneuvers for laryngoscopy are more challenging prior to anesthesia induction because of restrictions related to stabilization of the cervical region from a cervical collar A preoperative evaluation of airway anatomy is crucial to determine the appropriate intubation methods. While there is no specific general anesthetic recommendation, attention should be given to maintain adequate spinal cord perfusion and prevent systemic hypotension. In addition, identifying presurgical neurologic dysfunction is important to properly assess for complications or further neuronal damage during the intraoperative period. This chapter identifies the important areas of perioperative management following acute SCI including anesthesia induction, hemodynamic challenges, fluid therapy, and postoperative pain management.


Trauma Neurotrauma Spinal cord injury Anesthesia Airway problems Intubation Autoregulation Hemodynamic instability Neuroprotection Fluid management Pain management 


Declaration of Interest

Authors declare no conflict of interest.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Onat Akyol
    • 1
    • 2
  • Cesar Reis
    • 1
    • 3
  • Vadim Gospodarev
    • 4
  • Haley Reis
    • 4
  • Shen Cheng
    • 5
  • John Zhang
    • 1
  • Richard L. ApplegateII
    • 6
    Email author
  1. 1.Department of Physiology and PharmacologyLoma Linda University School of MedicineLoma LindaUSA
  2. 2.Department of AnesthesiologyBağcılar Training and Research HospitalİstanbulTurkey
  3. 3.Department of Preventive MedicineLoma Linda University Medical CenterLoma LindaUSA
  4. 4.Loma Linda School of MedicineLoma LindaUSA
  5. 5.Department of Neurosurgery, Second Affiliated Hospital, School of MedicineZhejiang UniversityHangzhouChina
  6. 6.Anesthesiology and Pain MedicineUniversity of California Davis HealthSacramentoUSA

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