ABSTRACT
Cervical spine trauma may result in injury to the vital neuronal pathways passing through the cervical spinal cord, and in its most severe forms, can result in tetraplegia, cardiorespiratory collapse, and death. It is a relatively common cause of severe disability in the younger age groups and can result not only in individual tragedies but also a significant direct and indirect economic burden on society as a whole.
Cervical spine trauma can present in isolation or in association with other serious injuries and patients may be critically ill, requiring multidisciplinary care. The anesthesiologist plays a crucial role in the management of patients presenting with cervical spine trauma and successful anesthetic management requires a thorough understanding of the type and nature of cervical spine injury, the extent of associated neurologic injuries, and their impact on other vital organ systems.
We provide an overview on functional anatomy, physiology, and biomechanics of the cervical spine and spinal cord. We present the commonly used classification systems for various types of cervical spine and spinal cord injury and their clinical and radiologic assessment. We discuss the principles of surgical management, including important considerations for nonoperative and operative strategies. Finally, we review anesthetic management principals, the competing priorities of cervical spine stabilization and emergent airway management and crucial anesthetic considerations for the preoperative and intraoperative phases with an overarching emphasis on the role the anesthesiologist plays in mitigating secondary neuronal injury.
