Our Summary

This research paper discusses the risks of neurological injury during aortic surgery. This can include spinal cord damage or stroke. Many studies and proposed solutions exist, but there is still no completely effective way to prevent or treat these injuries. The paper reviews what we know about these injuries, how they happen, and how to assess the risk. It also discusses established and emerging strategies to protect the nervous system during surgery.

FAQs

  1. What are the potential neurological injuries that can occur during aortic surgery?
  2. What are some established and emerging strategies to protect the nervous system during surgery?
  3. Is there a completely effective way to prevent or treat neurological injuries during aortic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal surgery is to follow all pre-operative and post-operative instructions carefully. This can include things like avoiding certain medications, getting plenty of rest, and attending physical therapy sessions as recommended. Following these instructions can help improve the success of the surgery and reduce the risk of complications.

Suitable For

Patients who are typically recommended for spinal surgery include those who have:

  1. Degenerative disc disease: This condition occurs when the discs between the vertebrae in the spine start to break down, causing pain and discomfort.

  2. Herniated disc: When the soft inner core of a disc in the spine leaks out through a tear in the outer layer, it can press on nearby nerves and cause pain, numbness, or weakness in the arms or legs.

  3. Spinal stenosis: This condition occurs when the spaces within the spine narrow, putting pressure on the spinal cord and nerves. This can cause pain, numbness, or weakness in the arms or legs.

  4. Scoliosis: A condition where the spine curves sideways, leading to pain, discomfort, and in severe cases, difficulty breathing.

  5. Spinal fractures: Fractures in the spine can be caused by trauma, osteoporosis, or other conditions, leading to instability and pain.

  6. Tumors: Spinal tumors can be benign or malignant and can cause pain, weakness, or loss of bladder or bowel control.

  7. Infections: Infections in the spine, such as spinal meningitis or discitis, can cause pain, fever, and neurological symptoms.

Overall, patients with severe, disabling symptoms that have not responded to non-surgical treatments such as physical therapy, medications, or injections may be recommended for spinal surgery. Additionally, patients with progressive neurological deficits, such as weakness or loss of sensation in the arms or legs, may also be candidates for surgery to prevent further damage.

Timeline

Before spinal surgery:

  1. Patient consults with a spine specialist to discuss symptoms and determine the need for surgery.
  2. Pre-operative tests and evaluations are conducted to assess the patient’s overall health and determine the best approach for surgery.
  3. The patient undergoes pre-surgical preparation, which may include instructions on medication management, diet, and physical activity.
  4. The surgical team discusses the procedure, potential risks, and post-operative care with the patient.

During spinal surgery:

  1. The patient is administered anesthesia and positioned on the operating table.
  2. The surgeon makes an incision and accesses the spine, performing the necessary procedures to address the spinal issue.
  3. Intraoperative monitoring may be used to assess neurological function and prevent injury to the spinal cord.
  4. The surgeon closes the incision and the patient is moved to the recovery area.

After spinal surgery:

  1. The patient wakes up in the recovery room and is monitored for any immediate post-operative complications.
  2. Pain management and physical therapy are initiated to help the patient recover and regain mobility.
  3. The patient is discharged from the hospital with instructions for at-home care and follow-up appointments.
  4. Follow-up visits with the surgeon are scheduled to monitor the patient’s progress and address any concerns or complications.

What to Ask Your Doctor

  1. What specific type of spinal surgery do I need and why?
  2. What are the potential risks and complications of the spinal surgery?
  3. How will the surgery be performed and what is the expected recovery time?
  4. What are the chances of experiencing neurological injury during the surgery?
  5. What steps will be taken to minimize the risk of neurological injury during the surgery?
  6. How will my neurological function be monitored during and after the surgery?
  7. What are the potential long-term effects of neurological injury from the surgery?
  8. What are the alternative treatment options to spinal surgery and their risks?
  9. How experienced is the surgical team in performing this specific type of spinal surgery?
  10. What is the success rate of this type of spinal surgery in terms of reducing pain and improving function?

Reference

Authors: Lindsay H, Srinivas C, Djaiani G. Journal: Best Pract Res Clin Anaesthesiol. 2016 Sep;30(3):283-303. doi: 10.1016/j.bpa.2016.05.002. Epub 2016 May 14. PMID: 27650340