Spinal Surgery and Neurocritical Care

Spinal surgery is associated with a high rate of systemic complications. Systematic reviews have found that the overall rate of early complications from spinal surgery ranged from 5.2% to 16.4% [1, 2]. The rates of early systemic complications differed based on the type of surgery and the surgical approaches. Major systemic complications, defined as clinical events that led to long-lasting sequelae or required further intervention, including repeat surgery, are as high as 28% in cervical spinal surgery and 24.2% in thoracic or lumbar spinal surgeries (Table 48.1) [3, 4]. In addition, perioperative spinal cord injury after spinal surgery is a devastating complication with incidence of 0–3%. High-risk surgical procedures include spinal stabilisation following trauma/tumours and correction of scoliosis. Furthermore, the care of high-level acute spinal cord injuries requires physiological monitoring and stabilisation preoperatively; spinal decompression and/or fixation are common surgical approaches with post-operative challenges due to intraoperative factors and long-term physiological changes.