Considerations and Anesthesiologic Complications in Spinal Surgery

  • Massimiliano CarassitiEmail author
  • Serena Antonelli
  • Demetrio Panzera
  • Felice Eugenio Agrò

The preoperative evaluation of the risks in patients undergoing cervical spine surgery is important, particularly in elderly patients with co-morbidities. About 30% of the elderly patients have three or more co-morbidities, and 80% have at least one co-morbidity with increased surgical risks.


Endotracheal Tube Vocal Cord Cardiac Risk Difficult Airway Direct Laryngoscopy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Lumb AB, Nunn IF (1991) Respiratory function and rib cage contribution to ventilation in body positions commonly used during anesthesia. Anesth Analg 73:422–426PubMedCrossRefGoogle Scholar
  2. 2.
    Pelosi P, Croci M (1995) The prone positioning during general anesthesia minimally affects respiratory mechanics while improving functional residual capacity and increasing oxygen tension. Anesth Analg 80:955–960PubMedGoogle Scholar
  3. 3.
    Pelosi P, Croci M (1996) Prone positioning improves pulmonary function in obese patients during general anesthesia. Anesth Analg 83:578–583PubMedGoogle Scholar
  4. 4.
    Gupta R, Batra S, Chandra R, Sharma VK (2008) Compartment syndrome with acute renal failure: a rare complication of spinal surgery in knee-chest position. Spine 33(8):E272–E273PubMedCrossRefGoogle Scholar
  5. 5.
    Moreno F, Lyons HA (1961) Effect of body posture on lung volumes. J Appl Physiol 16:27–29PubMedGoogle Scholar
  6. 6.
    Palmon SC, Kirsch JR (1998) The effect of the prone position on pulmonary mechanics is frame-dependent. Anesth Analg 87:1175–1180PubMedGoogle Scholar
  7. 7.
    Chung MS, Son JH (2006) Visual loss in one eye after spinal surgery. Korean J Ophthalmol 20(2):139–142PubMedCrossRefGoogle Scholar
  8. 8.
    Kasodekar VB, Chen JL (2006) Monocular blindness: a complication of intraoperative positioning in posterior cervical spine surgery. Singapore Med J 47(7):631–633PubMedGoogle Scholar
  9. 9.
    Takahata M, Ito M, Abumi K et al (2008) Clinical results and complications of circumferential spinal cord decompression through a single posterior approach for thoracic myelopathy caused by ossification of posterior longitudinal ligament. Spine 33(11):1199–1208PubMedCrossRefGoogle Scholar
  10. 10.
    Agrò F, Barzoi G, Montecchia F (2003) Tracheal intubation using a Macintosh laryngoscope or a glidescope in 15 patients with cervical spine immobilization. Br J Anaesth 90(5):705–706PubMedCrossRefGoogle Scholar
  11. 11.
    Agrò F, Hung OR, Cataldo R et al (2001) Lightwand intubation using the trachlight: a brief review of current knowledge. Can J Anaesth 48(6):592–599PubMedCrossRefGoogle Scholar
  12. 12.
    Robitaille A, Williams SR, Tremblay MH (2008) Cervical spine motion during tracheal intubation with manual in-line stabilization: direct laryngoscopy versus glidescope video-laryngoscopy. Anesth Analg 106(3):935–941PubMedCrossRefGoogle Scholar
  13. 13.
    Agrò F, Brimacombe J, Verghese C et al (1998) Laryngeal mask airway and incidence of gastro-oesophageal reflux in paralysed patients undergoing ventilation for elective orthopaedic surgery. Br J Anaesth 81(4):537–539PubMedCrossRefGoogle Scholar
  14. 14.
    Kihara S, Watanabe S, Brimacombe J et al (2000) Segmental cervical spine movement with the intubating laryngeal mask during manual in-line stabilization in patients with cervical pathology undergoing cervical spine surgery. Anesth Analg 91(1):195–200PubMedGoogle Scholar
  15. 15.
    Agrò F, Antonelli S, Mattei A (2001) The proseal LMA: preliminary data. Br J Anaesth 86(4):601–602PubMedGoogle Scholar
  16. 16.
    Agrò F, Barzoi G, Montecchia F (2003) The oesophageal tracheal combitube: a pilot study on airflow resistance and ventilatory pressures in 26 anaesthetised patients. Anaesthesia 58(7):722–723PubMedCrossRefGoogle Scholar
  17. 17.
    Agrò F, Frass M, Benumof JL et al (2002) Current status of the Combitube: a review of the literature. J Clin Anesth 14(4):307–314PubMedCrossRefGoogle Scholar
  18. 18.
    Degoute CS (2007) Controlled hypotension: a guide to drug choice. Drugs 67(7):1053–1076PubMedCrossRefGoogle Scholar
  19. 19.
    Dutton RP (2004) Controlled hypotension for spinal surgery. Eur Spine J 13:S66–S71PubMedCrossRefGoogle Scholar
  20. 20.
    Fenger-Eriksen C, Hartig Rasmussen C, Kappel Jensen T et al (2005) Renal effects of hypotensive anaesthesia in combination with acute normovolaemic haemodilution with hydroxyethyl starch 130/0.4 or isotonic saline. Acta Anaesthesiol Scand 49(7):969–974PubMedCrossRefGoogle Scholar
  21. 21.
    Kadam PP, Saksena SG, Jagtap SR et al (1993) Hypotensive anaesthesia for spine surgery–nitroglycerin vs halothane. J Postgrad Med 39(1):26–28PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Massimiliano Carassiti
    • 1
    Email author
  • Serena Antonelli
    • 1
  • Demetrio Panzera
    • 1
  • Felice Eugenio Agrò
    • 1
  1. 1.Department of AnesthesiaUniversity School of Medicine CampusRomeItaly

Personalised recommendations