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Spinal cord injury arising in anaesthesia practice
D W Hewson1, N M Bedforth1, J G Hardman2
1Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Anaesthesia
|January 10, 2018
Summary
Spinal cord injury during anesthesia is rare but serious. This review covers causes like patient positioning, hypoperfusion, and neuraxial techniques, offering evidence-based prevention strategies.
Area of Science:
- Anesthesiology
- Neurology
- Neurosurgery
Background:
- Spinal cord injury (SCI) during anesthesia is a rare but significant complication.
- It leads to substantial morbidity and mortality.
- Causes can be directly related to anesthesia or indirect surgical factors.
Purpose of the Study:
- To review the pathophysiology of SCI during anesthesia.
- To discuss various causes including patient positioning, hypoperfusion, and neuraxial techniques.
- To present evidence-based measures for reducing SCI incidence and severity.
Main Methods:
- Literature review of SCI pathophysiology.
- Discussion of specific SCI causes: vertebral canal hematoma, spinal epidural abscess, meningitis, adhesive arachnoiditis.
- Analysis of anesthesia-related vs. surgical factors contributing to SCI.
Main Results:
- SCI can result from direct anesthetic conduct (e.g., spinal needle injury) or indirect surgical factors (e.g., aortic surgery ischemia).
- Serious causes include hematoma, abscess, meningitis, and arachnoiditis.
- Preventive measures can mitigate incidence and severity.
Conclusions:
- Understanding SCI pathophysiology is crucial for anesthesiologists.
- Clinicians can implement practical strategies to minimize SCI risks.
- Multifactorial causes necessitate a comprehensive approach to SCI prevention during anesthesia.
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