Spinal Cord Injuries Part 4: Care Following OR Procedures-Handout: Spinal Cord Injuries Part 4: Care Following OR Procedures

Handout: Spinal Cord Injuries Part 4: Care Following OR Procedures

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This document is a summary of Part 4 of an article published by the Trauma Center Association of America on November 20, 2023. The article focuses on key concerns for patients with spinal cord injuries before and after surgery.<br /><br />Before surgery, key concerns for spinal cord injury patients include immobilization, appropriate imaging studies, spinal shock, and factors such as diabetes and age. It is important to analyze the injury and decide on the appropriate immobilization device. Imaging studies should be done to determine the stability of the injury. Spinal shock, hypotension, and the patient's age should also be considered before surgery.<br /><br />After surgery, key concerns for spinal cord injury patients include spinal shock, maintaining adequate mean arterial pressure (MAP), draining cerebrospinal fluid (CSF), reducing immobilization, and early mobilization. Spinal shock and hypotension should be monitored and managed. The duration of immobilization and the use of a brace should be planned to prevent complications. Early mobilization is important for patients to reduce the risk of pressure ulcers and improve circulation.<br /><br />The document also discusses decision-making in the operating room when complications arise, such as changes in neuromonitoring, excessive bleeding, and cerebrospinal fluid leaks. Cardiac issues and patient coding in the operating room are also topics of consideration.<br /><br />Additionally, the document addresses DVT prophylaxis after spine surgery. Graduated compression stockings (GCS) can be used to prevent DVT. The article poses questions regarding the use of DVT prophylaxis after spine surgery in both elective spine surgery and spinal cord injury cases. Factors such as the type of surgery, type of spinal cord injury, and patient characteristics should be considered when determining the use of DVT prophylaxis.<br /><br />Overall, the article provides insights into the care and management of spinal cord injury patients before and after surgery, addressing various concerns and considerations.

Keywords

spinal cord injuries

surgery

immobilization

imaging studies

spinal shock

diabetes

age

mean arterial pressure

cerebrospinal fluid

early mobilization