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Related Concept Videos

Spinal Cord01:26

Spinal Cord

458
The spinal cord, a critical component of the central nervous system, extends from the base of the brainstem to the lumbar region of the vertebral column. It is essential for maintaining physical stability and facilitating communication between the brain and peripheral parts of the body.
458
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

623
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Related Experiment Video

Updated: Jun 29, 2025

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion
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Definition, Frequency and Risk Factors for Intra-Operative Spinal Cord Injury: A Knowledge Synthesis.

Michael G Fehlings1,2,3, Ayesha Quddusi3, Andrea C Skelly4

  • 1Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Global Spine Journal
|March 25, 2024
PubMed
Summary
This summary is machine-generated.

Intra-operative spinal cord injury (ISCI) is defined as new neurological deficit during spine surgery. Risk factors include older age, male sex, cardiovascular disease, and severe myelopathy, while IONM use decreases risk.

Keywords:
intra-operative spinal cord injuryneurospinal cord injurytrauma

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Neurology

Background:

  • Intra-operative spinal cord injury (ISCI) is a severe complication of spinal surgery.
  • Lack of a uniform ISCI definition leads to variable reported frequencies and risk factors.
  • A knowledge synthesis was performed to address these gaps.

Purpose of the Study:

  • To establish a uniform definition for ISCI.
  • To determine the frequency of ISCI.
  • To identify clinical and imaging risk factors for ISCI.

Main Methods:

  • A mixed-methods approach combining a scoping review and a systematic review.
  • Scoping review to define ISCI frequency and definitions.
  • Systematic review to identify ISCI risk factors, adhering to PRISMA standards.

Main Results:

  • ISCI frequency ranged from 0% to 61%.
  • Risk factors for ISCI include older age, male sex, cardiovascular disease, severe myelopathy, blood loss, and specific spinal pathologies.
  • Intra-operative neuromonitoring (IONM) and better pre-operative neurological status were associated with decreased ISCI risk.

Conclusions:

  • ISCI is defined as new/worsening neurological deficit during or immediately after spine surgery.
  • Identified clinical and imaging factors can aid clinicians in assessing ISCI risk.
  • This study provides a clear definition and risk factor profile for ISCI.