Anesthesia for Spine Surgery - Spinal Cord Perfusion
is a topic covered in the Clinical Anesthesia Procedures
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Spinal cord perfusion may be compromised by the trauma itself, surgical manipulation, and hemodynamic changes. Similar to cerebral perfusion pressure, spinal cord perfusion pressure (SCPP) is determined by mean arterial pressure (MAP) and intraspinal pressure (ISP) (or central venous pressure if it is greater than ISP) (SCPP = MAP – ISP). Vessel injury (decreased local blood flow delivery), hypotension (decreased MAP), and obstruction to blood flow (either segmental or elevated ISP) will decrease SCPP. Methods to maximize SCPP include setting elevated MAP goals to maximize delivery, and recent studies have demonstrated utility of intraspinal pressure monitoring and cerebrospinal fluid drainage to minimize obstruction to blood flow (10,11).
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Pino, Richard M., editor. "Anesthesia for Spine Surgery - Spinal Cord Perfusion." Clinical Anesthesia Procedures, 9th ed., Wolters Kluwer, 2019. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728473/all/Anesthesia_for_Spine_Surgery___Spinal_Cord_Perfusion.
Anesthesia for Spine Surgery - Spinal Cord Perfusion. In: Pino RM, ed. Clinical Anesthesia Procedures. 9th ed. Wolters Kluwer; 2019. https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728473/all/Anesthesia_for_Spine_Surgery___Spinal_Cord_Perfusion. Accessed October 22, 2019.
Anesthesia for Spine Surgery - Spinal Cord Perfusion. (2019). In Pino, R. M. (Ed.), Clinical Anesthesia Procedures. Available from https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728473/all/Anesthesia_for_Spine_Surgery___Spinal_Cord_Perfusion
Anesthesia for Spine Surgery - Spinal Cord Perfusion [Internet]. In: Pino RM, editors. Clinical Anesthesia Procedures. Wolters Kluwer; 2019. [cited 2019 October 22]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728473/all/Anesthesia_for_Spine_Surgery___Spinal_Cord_Perfusion.
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