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14 - Anesthesia for Spinal Cord Trauma

Published online by Cambridge University Press:  18 January 2010

By
M. Sean Kincaid  and
Arthur M. Lam
Edited by
Charles E. Smith
M. Sean Kincaid
Affiliation:
Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington
Arthur M. Lam
Affiliation:
Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington
Charles E. Smith
Affiliation:
Case Western Reserve University, Ohio
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Summary

Objectives

  1. Review the prevalence and types of spinal cord injuries.

  2. Evaluate airway management choices in patients with spinal cord injuries.

  3. Review the implications of spinal cord injuries on intraoperative anesthetic management.

  4. Discuss the anesthetic implications of neuromonitoring in patients with spinal cord injuries.

Spinal cord injury (SCI) is a common traumatic injury that often requires hospitalization and surgical intervention. As a result, the anesthesiologist encounters many patients with SCI at various stages of their hospitalization, both in and out of the operating room. There are several aspects of their care, including airway management, initial resuscitation, and intraoperative management, that require a particular understanding of their disease and for which the anesthesiologist is particularly suited.

PREVALENCE AND ETIOLOGY OF SPINAL CORD INJURY

Spinal column injury encompasses a wide range of pathologies, from the minor to the life-threatening. The bony structure of the spine encloses, protects, and supports the spinal cord. Injury may occur anywhere from the articulation of the cervical spine with occiput to the sacrum. It may include fractures of the bone or ligamentous injury, and it may or may not have underlying cord damage, the presence of which would define SCI. Insult to the cord comprises a spectrum of disease depending on the location of the injury and the nature of the deficit (see Chapter 13).

A population-based study evaluating spinal column injury in a Canadian community demonstrated less than a 6 percent incidence of neurologic injury in persons who sustain a spinal column fracture [1].

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Trauma Anesthesia , pp. 213 - 224
Publisher: Cambridge University Press
Print publication year: 2008

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  • Anesthesia for Spinal Cord Trauma
    • By M. Sean Kincaid, Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington, Arthur M. Lam, Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.017
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  • Anesthesia for Spinal Cord Trauma
    • By M. Sean Kincaid, Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington, Arthur M. Lam, Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.017
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  • Anesthesia for Spinal Cord Trauma
    • By M. Sean Kincaid, Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington, Arthur M. Lam, Department of Anesthesiology, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.017
Available formats
×