Cervical Spinal Cord, Root, and Bony Spine Injuries
Adult
Male
Databases, Factual
Posture
Anesthesia, General
Middle Aged
Patient Positioning
United States
3. Good health
Insurance Claim Review
03 medical and health sciences
0302 clinical medicine
Anesthesiology
Spinal Injuries
Cervical Vertebrae
Humans
Female
Spondylosis
Spinal Nerve Roots
Societies, Medical
Spinal Cord Injuries
DOI:
10.1097/aln.0b013e3182104859
Publication Date:
2011-02-16T10:33:53Z
AUTHORS (9)
ABSTRACT
Background
The aim of this study was to characterize cervical cord, root, and bony spine claims in the American Society of Anesthesiologists Closed Claims database to formulate hypotheses regarding mechanisms of injury.
Methods
All general anesthesia claims (1970-2007) in the Closed Claims database were searched to identify cervical injuries. Three independent teams, each consisting of an anesthesiologist and neurosurgeon, used a standardized review form to extract data from claim summaries and judge probable contributors to injury.
Results
Cervical injury claims (n = 48; mean ± SD age 47 ± 15 yr; 73% male) comprised less than 1% of all general anesthesia claims. When compared with other general anesthesia claims (19%), cervical injury claims were more often permanent and disabling (69%; P < 0.001). In addition, cord injuries (n = 37) were more severe than root and/or bony spine injuries (n = 10; P < 0.001), typically resulting in quadriplegia. Although anatomic abnormalities (e.g., cervical stenosis) were often present, cord injuries usually occurred in the absence of traumatic injury (81%) or cervical spine instability (76%). Cord injury occurred with cervical spine (65%) and noncervical spine (35%) procedures. Twenty-four percent of cord injuries were associated with the sitting position. Probable contributors to cord injury included anatomic abnormalities (81%), direct surgical complications (24% [38%, cervical spine procedures]), preprocedural symptomatic cord injury (19%), intraoperative head/neck position (19%), and airway management (11%).
Conclusion
Most cervical cord injuries occurred in the absence of traumatic injury, instability, and airway difficulties. Cervical spine procedures and/or sitting procedures appear to predominate. In the absence of instability, cervical spondylosis was the most common factor associated with cord injury.
SUPPLEMENTAL MATERIAL
Coming soon ....
REFERENCES (79)
CITATIONS (75)
EXTERNAL LINKS
PlumX Metrics
RECOMMENDATIONS
FAIR ASSESSMENT
Coming soon ....
JUPYTER LAB
Coming soon ....