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  4. Spinal Cord Injury and Complications Related to Neuraxial Anaesthesia Procedures: A Systematic Review

Spinal Cord Injury and Complications Related to Neuraxial Anaesthesia Procedures: A Systematic Review

Int. J. Mol. Sci., 2023 · DOI: 10.3390/ijms24054665 · Published: February 28, 2023

Spinal Cord InjuryAnesthesiology

Simple Explanation

Neuraxial procedures like spinal and epidural anesthesia can lead to complications, including rare spinal cord injuries. This review identifies high-risk patients and summarizes the causes, consequences, and management of these injuries. The review found that extremes of age, obesity, and diabetes are major risk factors. Spinal cord injuries can result from hematomas, trauma, abscesses, ischemia, and infarction, leading to motor deficits, sensory loss, and pain. Despite these risks, neuraxial techniques remain valuable for pain management, reducing morbidity, improving outcomes, shortening hospital stays, and preventing chronic pain, offering economic benefits with careful patient management and monitoring.

Study Duration
Article search performed between 2022-10-12 and 2022-11-18
Participants
40 patients with Anaes-SCI in case reports/series and 41,251 patients in prospective/retrospective studies
Evidence Level
Systematic Review of case reports, case series, prospective and retrospective studies

Key Findings

  • 1
    The main risk factors for Anaes-SCI were extremes of age, obesity, and diabetes.
  • 2
    Anaes-SCI can result from hematoma, trauma, abscess, ischemia, and infarction.
  • 3
    Motor deficits, sensory loss, and pain are the primary consequences of Anaes-SCI, with delayed treatments often reported.

Research Summary

This systematic review investigates spinal cord injuries (SCI) resulting from neuraxial anesthesia, aiming to identify high-risk patients and summarize causes, consequences, and management strategies. The review of 31 studies highlights risk factors like extremes of age, obesity, and diabetes, with SCI resulting from hematoma, trauma, abscess, ischemia, and infarction, leading to motor deficits, sensory loss, and pain. Despite potential complications, neuraxial techniques remain crucial for pain management, reducing morbidity, improving patient outcomes and reducing hospital stay, emphasizing the importance of careful patient management and monitoring.

Practical Implications

Enhanced Patient Monitoring

Close monitoring during neuraxial anesthesia procedures is crucial to minimize the risk of spinal cord injury and complications.

Risk Factor Awareness

Healthcare providers should be aware of the risk factors such as extremes of age, obesity, and diabetes to identify high-risk patients.

Prompt Treatment

Early diagnosis and treatment of Anaes-SCI are essential to improve patient outcomes.

Study Limitations

  • 1
    The very low number of reported cases
  • 2
    Exclusion of manuscripts written in languages other than English
  • 3
    Focus on case reports and series may limit generalizability

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