Reducing the Risk of Spinal Cord Injury in Patients With Asymptomatic Cervical Stenosis Undergoing Cardiac and Vascular Surgery

NECK HYPEREXTENSION is used commonly during surgical positioning to provide optimal anatomic positioning and exposure. Iatrogenic tetraplegia has been reported in patients with asymptomatic cervical stenosis after prolonged neck extension during cardiac and noncardiac surgeries. Standardized protocols to screen patients for underlying degenerative cervical disease, such as cervical spondylotic myelopathy or cervical stenosis, have been shown to alter perioperative decision-making. 1 Diaz A Chin C Burks SS et al. A retrospective pilot study for preoperative screening to prevent iatrogenic cervical spinal cord injury. Cureus. 2021; 13: e12550 PubMed Google Scholar Here, the authors present the case of a patient with a significant risk of intraoperative spinal cord injury during combined cardiac and vascular surgery, which was managed successfully without complication. They discuss the pathophysiology, prevention, and treatment of this devastating complication.