Postoperative care in the neuro-intensive care unit

The postoperative care of the spine surgery patient requires a multidisciplinary approach between the spine surgeon, the intensive care team, as well as an approach surgeon, if one was involved in the procedure. A thorough examination of the postoperative spine patient is vital to elucidate any new deficits that have occurred as a result of a surgical complication and to facilitate rapid treatment. The level of prophylaxis for deep vein thrombosis should be tailored depending on the procedure being performed and the patient’s comorbidities. Airway compromise is a potentially lethal complication following cervical spine surgery and should be closely monitored in the postoperative period. Anterior thoracic and lumbar spine procedures can be complicated by respiratory or gastrointestinal related symptoms due to the manipulation of the relevant structures during the approach. Introduction Postoperative care of the spine surgery patient can be very complex. Often times, these patients require the attention provided in an intensive care setting. In order for members of the intensive care team to adequately care for the patient, it is imperative that the team is equipped with a baseline understanding of different spinal surgical procedures and how each procedure can uniquely affect the patient in the postoperative setting. In this chapter, a brief overview of the pertinent spinal anatomy will be reviewed. This will be followed by a review of general considerations for all postoperative spine surgery patients. Finally, segments of the spine will be discussed individually, and the complications related to approaches specific to each segment will be reviewed.