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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2019; 06(03): 213-221
DOI: 10.1055/s-0039-1694688
Review Article
Indian Society of Neuroanaesthesiology and Critical Care

Early Management of Acute Spinal Cord Injury—Part I: Initial Injury to Surgery

Amanda Sacino
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Kathryn Rosenblatt
2   Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
3   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
› Author Affiliations Funding Kathryn Rosenblatt, MD, MHS, is supported by the Stimulating and Advancing ACCM Research (StAAR) Mentored Research Grant from the Johns Hopkins Department of Anesthesiology and Critical Care Medicine.
Further Information

Publication History

Received: 01 February 2019

Accepted after revision: 06 June 2019

Publication Date:
13 September 2019 (online)

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Abstract

Acute spinal cord injury is a devastating event associated with substantial morbidity worldwide. The pathophysiology of spinal cord injury involves the initial mechanical trauma and the subsequent inflammatory response, which may worsen the severity of neurologic dysfunction. Interventions have been studied to reduce the extent of primary injury to the spinal cord through preventive measures and to mitigate secondary insult through early specialized care. Management, therefore, is multifold, interdisciplinary, and begins immediately at the time of injury. It includes the trauma triage, acute management of the circulatory and respiratory systems, and definitive treatment, mainly with surgical decompression and stabilization.

Keywords

airway management - bradycardia - blood pressure targets - intraoperative neuromonitoring - neurogenic shock - respiratory arrest - resuscitation - spinal cord injury - spinal shock - surgical decompression
 

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