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Neurosurgery and Spine Procedures in Cancer Patients

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Oncologic Critical Care
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Abstract

Patients with tumors in and around the spinal cord present many challenges to the physicians that care for them. Patient symptoms can range from sensory and motor dysfunction to extreme pain due to nerve impingement and pathological fractures. There is a multitude of factors that make the perioperative course for these patients complicated. Airway management, positioning, blood and fluid management, postoperative pain control, and thromboembolism are some potential problems these patients will encounter. This chapter will help identify and discuss the perioperative management of these patients.

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References

  1. Ackerman L, Traynelis V. Treatment of delayed onset neurological deficit after aortic surgery with lumbar cerebrospinal fluid drainage. Neurosurgery. 2002; 51:1414–21.

    Article  Google Scholar 

  2. Adogwa O, Elsamadicy A, Fialkoff J, et al. Early ambulation decreases length of hospital stay, peri-operative complications and improves functional outcomes in elderly patients undergoing surgery for correction of adult degenerative scoliosis. Spine. 2017;42:1429–5.

    Article  Google Scholar 

  3. Agnelli G, Piovella F, Buoncristiani P, et al. Enoxaparin plus compression stockings compared with compression stockings alone in the prevention of venous thromboembolism after elective neurosurgery. N Engl J Med. 1998;339:80–5.

    Article  CAS  Google Scholar 

  4. American Society of Anesthesiologists Task Force of Perioperative Visual Loss. Practice advisory for perioperative visual loss associated with spine surgery. Anesthesiology. 2012;116:274–85.

    Article  Google Scholar 

  5. Barker F II. Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis. Neurosurgery. 2002;51:391–400.

    Article  Google Scholar 

  6. Buvanendran A, Kroin J. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol. 2009;22:588–93.

    Article  Google Scholar 

  7. Classen D, Evans R, Pestotnik S, et al. The timing of prophylactic antibiotics and the risk of surgical wound infection. N Engl J Med. 1992;326:281–6.

    Article  CAS  Google Scholar 

  8. Daly J, Redmond H, Gallagher H. Perioperative nutrition in cancer patients. J Parenter Enter Nutr. 1992;16:100S–5S.

    Article  CAS  Google Scholar 

  9. Dearborn J, Hu S, Tribus C, et al. Thromboembolic complications after major thoracolumbar spine surgery. Spine. 1999;24:1471–6.

    Article  CAS  Google Scholar 

  10. DeWald R, Arlet V, Carl A, et al., editors. Spinal deformities: the comprehensive text. New York: Thieme; 2003.

    Google Scholar 

  11. Dodwell E, Latorre J, Parisini E, et al. NSAID exposure and risk of nonunion: a meta-analysis of case-control and cohort studies. Calcif Tissue Int. 2010;87:193.

    Article  CAS  Google Scholar 

  12. Epstein N. A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures. Surg Neurol Int. 2014; 5(suppl 3):S66–73.

    Article  Google Scholar 

  13. Ferree B, Wright A. Deep venous thrombosis following posterior lumbar spinal surgery. Spine. 1993; 18:1079–82.

    Article  CAS  Google Scholar 

  14. Feyissa A, Tummala S. Intraoperative neurophysiologic monitoring with Hoffmann reflex during thoracic spine surgery. J Clin Neurosci. 2015;22:990.

    Article  Google Scholar 

  15. Fourney D, Schomer D, Nadar R, et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg. 2003;98:21–30.

    Article  Google Scholar 

  16. Fu K, Smith J, Polly D, et al. Correlation of higher preoperative American society of anesthesiology grade and increased morbidity and mortality rates in patients undergoing spine surgery. J Neurosurg Spine. 2011;14:470.

    Article  Google Scholar 

  17. Gottfried O, Schloesser P, et al. Embolization of metastatic spinal tumors. Neurosurg Clin. 2004;15(4): 391–9.

    Article  Google Scholar 

  18. Guzman R, Dubach-Schwizer S, et al. Preoperative transarterial embolization of vertebral metastases. Eur Spine J. 2005;14(3):263–8.

    Article  Google Scholar 

  19. Hansen M, Nellissery M, Bhatia P. Common mechanisms of osteosarcoma and paget’s disease. J Bone Miner Res. 1999;14(Suppl 2):39.

    Article  Google Scholar 

  20. Iorio A, Agnelli G. Low-molecular weight and unfractionated heparin for prevention of venous thromboembolism in neurosurgery: a meta-analysis. Arch Intern Med. 2000;160:2327–32.

    Article  CAS  Google Scholar 

  21. Janning S, Rybak M. Antimicrobial prophylaxis in surgery. In: Dipro J, Talbert R, Yee G, Matzke G, Wells B, Posey L, editors. Pharmacotherapy: a pathophysiologic approach. Stamford: Appleton & Lange; 1999. 1888–1889.

    Google Scholar 

  22. Kernodle D, Barg N, Kaiser A, et al. Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antimicrobial prophylaxis. Antimicrob Agents Chemother. 1988;32:202–8.

    Article  CAS  Google Scholar 

  23. Lee M, Rezai A, Freed D, et al. Intramedullary spinal cord tumors in neurofibromatosis. Neurosurgery. 1996;38(1):32–7.

    Article  CAS  Google Scholar 

  24. Levi A, Dickman C, Sonntag V, et al. Management of postoperative infections after spinal instrumentation. J Neurosurg. 1997;86:975–80.

    Article  CAS  Google Scholar 

  25. McDaid C, Maund E, Rice S, et al. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review. Health Technol Assess. 2010;14:1.

    Article  CAS  Google Scholar 

  26. McPhee I, Williams R, Swanson C. Factors influencing wound healing after surgery for metastatic disease of the spine. Spine. 1998;23:726–32.

    Article  CAS  Google Scholar 

  27. Nowicki R. Contin Educ Anaesth Crit Care Pain. 2014;14(4):147–52.

    Article  Google Scholar 

  28. Osborn I, Naruse R, Ferrario L. Airway management in neurosurgical patients. In: Hagberg C, Artime C, Aziz M, editors. Hagberg and benumof’s airway management. 4th ed. Philadelphia: Elsevier; 2018. p. 729–30.

    Google Scholar 

  29. Owen J. The application of intraoperative monitoring during surgery for spinal deformity. Spine. 1999;24:2649–62.

    Article  CAS  Google Scholar 

  30. Park J, Hyun S. Intraoperative neurophysiological monitoring in spinal surgery. World J Clin Cases. 2015;3(9):765–73.

    Article  Google Scholar 

  31. Raw D, Beattie J, et al. Anaesthesia for spinal surgery in adults. Br J Anaesth. 2003;91(6):886–904.

    Article  CAS  Google Scholar 

  32. Rokito S, Schwartz M, Neuwirth M. Deep vein thrombosis after major reconstructive spinal surgery. Spine. 1996;21:853–8.

    Article  CAS  Google Scholar 

  33. Samartzis D, Gillis C, et al. Intramedullary spinal cord tumors: part I-epidemiology, pathophysiology, and diagnosis. Global Spine J. 2015;5(5):425–35.

    Article  Google Scholar 

  34. Schmidt P, Ruchelli G, Mackey S, et al. Perioperative gabapentinoids: choice of agent, dose, timing, and effects on chronic postsurgical pain. Anesthesiology. 2013;119:1215.

    Article  Google Scholar 

  35. Sevick R, Wallace C. MR imaging of neoplasms of the lumbar spine. Magn Reson Imaging Clin N Am. 1999;7:539.

    CAS  PubMed  Google Scholar 

  36. Shrivastava R, Epstein F, Perin N, et al. Intramedullary spinal cord tumors in patients older than 50 years of age. Management and outcome analysis. J Neurosurg Spine. 2005;2:249.

    Article  Google Scholar 

  37. Stacchiotti S, Casali P, Lo Vullo S, et al. Chordoma of the mobile spine and sacrum: a retrospective analysis of a series of patients surgically treated at two referral centers. Ann Surg Oncol. 2010;17:211.

    Article  Google Scholar 

  38. Stambough J, Beringer D. Postoperative wound infections complicating adult spine surgery. J Spinal Disord. 1992;5:277–85.

    Article  CAS  Google Scholar 

  39. Tiippana E, Hamunen K, Kontinen V, et al. Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anes Analg. 2007;104:1545.

    Article  CAS  Google Scholar 

  40. Ubags L, Kalkman C, Been H, et al. The use of ketamine or etomidate to supplement sufentanil/N2O anesthesia does not disrupt monitoring of myogenic transcranial motor evoked responses. J Neurosurg Anesthesiol. 1997;9:228–33.

    Article  CAS  Google Scholar 

  41. Voth D, Schwarz M, Hahn K, et al. Prevention of deep vein thrombosis in neurosurgical patients: a prospective double-blind comparison of two prophylactic regimen. Neurosurg Rev. 1992;15:289–94.

    Article  CAS  Google Scholar 

  42. Waldron J, Laperriere N, Jaakkimainen L, et al. Spinal cord ependymomas: a retrospective analysis of 59 cases. Int J Radiat Oncol Biol Phys. 1993;27:223.

    Article  CAS  Google Scholar 

  43. Waring W, Karunas R. Acute spinal cord injuries and the incidence of clinically occurring thromboembolic disease. Paraplegia. 1991;29:8–16.

    CAS  PubMed  Google Scholar 

  44. Warner M. Postoperative visual loss: experts, data, and practice. Anesthesiology. 2006;105:641.

    Article  Google Scholar 

  45. Welch W, Jacobs G. Surgery for metastatic spinal disease. J Neuro-Oncol. 1995;23:163.

    Article  CAS  Google Scholar 

  46. Zufferey P, Merquiol F, Laporte S, et al. Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery? Anesthesiology. 2006;105:1034.

    Article  Google Scholar 

  47. Zufferey P, Lanoiselee J, Chapelle C, et al. Tranexamic acid bolus plus infusion is not more effective than a single bolus in primary hip arthroplasty: a randomized controlled trial. Anesthesiology. 2017;127:413.

    Article  CAS  Google Scholar 

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Correspondence to John Wiemers .

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Wiemers, J., Tatsui, C.E. (2020). Neurosurgery and Spine Procedures in Cancer Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74588-6_154

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  • DOI: https://doi.org/10.1007/978-3-319-74588-6_154

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74587-9

  • Online ISBN: 978-3-319-74588-6

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