Surgery of the Infected Spine and Spinal Cord Function
The surgical treatment of spinal infections has taught us a great deal about the pathophysiology of the spinal cord. In the past 15 years at St. Luke’s—Roosevelt, we have operated on 23 patients with various forms of Pott’s paraplegia and done 61 anterior explorations for pyogenic infections in 57 patients (cervical 24, thoracic 14, lumbar 23). During the same period, we have done more than 250 anterior explorations of the spine for tumor. Successful surgery required adequate decompression and maintenance of bony stability. Surgical cases in our series of spinal infections presented a myriad of combinations of cord compression and spinal instability. In my discussion of the cases presented, we will point out that the blood supply of the spinal cord does not appear to be precarious. Cord infarction from the anterior transthoracic surgery does not appear to be a problem. We believe that the deleterious effects of infection arise from mechanical compression, not from “arteritis or phlebitis,” and that it is rare in spinal surgery to have a vascular spinal cord complication except in the vigorous correction of scoliosis.
KeywordsHepatitis Tuberculosis Adduct Immobilization Decadron
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