Our Summary

This research paper discusses the most common neurological issues that can arise during and after surgery. Neurological status is significant for patients, as it can impact their recovery and overall health. The research focuses on conditions like cognitive disorders that can occur during surgery, lack of blood flow to the spinal cord, strokes during surgery, and loss of sight after surgery. The paper suggests that anesthesiologists can use certain strategies to prevent or treat these issues. The main takeaway is that it’s crucial for medical practitioners to understand these potential neurological threats to provide the best care for their patients.

FAQs

  1. What are the most common perioperative neurologic complications in spinal surgery?
  2. What strategies can anesthesiologists use to prevent or treat perioperative neurocognitive disorders, spinal cord ischemia, perioperative stroke, and postoperative visual loss?
  3. Why is a thorough understanding of threats to patients’ neurologic well-being essential in clinical practice?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal surgery is to follow all pre-operative instructions carefully, including any restrictions on medications, food, and drink. Additionally, it is important to communicate any concerns or changes in symptoms to your healthcare team before and after surgery. Finally, following a post-operative rehabilitation plan as prescribed by your healthcare provider can help ensure a successful recovery.

Suitable For

Patients who may be recommended for spinal surgery typically include those with severe back or neck pain that has not responded to conservative treatments such as physical therapy, medication, or injections. Other patients who may be recommended for spinal surgery include those with spinal deformities, spinal instability, spinal tumors, herniated discs, spinal cord compression, or spinal stenosis. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if spinal surgery is the best course of action for their specific condition.

Timeline

Before spinal surgery:

  1. Patient consults with a spine specialist to discuss symptoms, potential treatment options, and surgical risks.
  2. Patient undergoes preoperative testing and evaluation to assess their overall health and determine if they are a suitable candidate for surgery.
  3. Patient receives education on the surgical procedure, postoperative care, and potential complications.
  4. Patient undergoes spinal surgery under general anesthesia, with the surgical team monitoring neurologic function throughout the procedure.
  5. Patient is closely monitored in the postoperative period for any signs of neurologic complications, such as numbness, weakness, or changes in sensation.

After spinal surgery:

  1. Patient is transferred to a recovery area, where they are monitored for any immediate neurologic complications, such as spinal cord injury or nerve damage.
  2. Patient is gradually mobilized and provided with pain management to aid in their recovery.
  3. Patient undergoes physical therapy to regain strength and function in the affected area.
  4. Patient is discharged from the hospital with instructions for home care and follow-up appointments with their healthcare provider.
  5. Patient continues to recover at home, with ongoing monitoring of their neurologic function and progress in healing.
  6. Patient may experience some degree of pain, discomfort, and limitations in mobility as they continue to recover from the surgery.
  7. Patient attends follow-up appointments with their healthcare provider to assess their progress and address any ongoing concerns or complications related to the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery include:

  1. What are the potential risks and complications associated with this spinal surgery procedure?
  2. How will my neurologic status be monitored during and after the surgery?
  3. What steps will be taken to prevent perioperative neurologic complications, such as spinal cord ischemia or stroke?
  4. What is the plan for pain management after the surgery, and how will this affect my neurologic function?
  5. How long is the expected recovery time, and when can I expect to regain normal neurologic function?
  6. What are the signs and symptoms of neurologic complications that I should watch for after the surgery?
  7. Are there any specific lifestyle changes or precautions I should take to protect my neurologic health post-surgery?
  8. Will I need any follow-up neurologic assessments or treatments after the surgery?
  9. What is the success rate for this type of spinal surgery in terms of preserving neurologic function?
  10. Are there any alternative treatment options that may be less invasive and have a lower risk of neurologic complications?

Reference

Authors: Vandiver MS, Vacas S. Journal: Curr Opin Anaesthesiol. 2020 Oct;33(5):661-667. doi: 10.1097/ACO.0000000000000905. PMID: 32769748