Anaesthesia for spinal surgery

Lumbar backache is one of the commonest causes of chronic debility in Western society, and surgery may be indicated for disc protrusion or degeneration, or to relieve nerve-root compression. Similar problems are also not uncommon in the cervical spine, and operative intervention is often necessary. Less commonly in the general population, surgery is undertaken as part of the management of rheumatoid disease, tuberculous spine, or to correct structural abnormalities. This article outlines the principles behind the anaesthetic management of patients presenting for the more common spinal procedures, with particular reference to the avoidance of neurological and other post-operative sequelae.