Anaesthesia for spinal surgery

Patients with and without spinal disease are at risk of neurological damage during anaesthesia, even when the surgery is not directed at the spine. Certain types of spinal surgery carry a substantial risk. Reports of spinal cord damage due to direct laryngoscopy are unconvincing. Evoked potential spinal cord monitoring is used increasingly during anaesthesia, and successful recording of potentials requires the co-operation of the anaesthetist. Airway problems are common in cervical spine disease, particularly if the disease affects the upper three vertebrae. Anterior surgical approaches to the craniocervical junction involve extensive surgery, with implications for airway management and nutrition.