Management of patients with transection injury of the spinal cord

Hippokratia 2005, 9(1):26-34

R Gbandi, Z Kanonidou
3rd Dpt Anesthesiology, Hippokratio General Hospital Thessaloniki, Thessaloniki, Greece


The pathophysiology of spinal cord trauma and particularly, of the cervical and upper thoracic spinal segment, is often associated with immediate threat to live and with very serious temporal and permanent changes in the function of the whole organism of the trauma victims. As a result, the patients require special anesthetic and intensive care management. By conscious and cooperative patients, a quick neurological evaluation of the sensory and motor reflexes provides immediate information necessary to identify a partial or a complete transection injury of the spinal cord. Associate injuries (e.g. fracture or hemorrhage) are observed in about 10% of the cases and most frequently involve the cervical spinal segment. In unconscious patients or in patients whose level of consciousness is impaired, the cervical spine must be immobilized to prevent a potential neural damage, until spinal cord injury is excluded. In acute situation, the intensive care of such patients may extend from few weeks to many months.