Perioperative Management of Spinal Tumors

Patients with cancer of the spine present many challenges to the surgeon, anesthesiologist, and critical care physician. Cancer affecting the spine may result in neurologic dysfunction and=or spinal instability that significantly impact the perioperative management of these patients. Airway management is made more difficult by the limited range of motion mandated in patients with cervical spine instability. Transfer and positioning of patients is more complicated when spinal segments are deemed unstable. If spinal cord or nerve root function is at risk during surgery, then neurophysiologic monitoring may be necessary, adding to the special requirements of anesthetic management and the overall complexity of patient monitoring.