PostOp Bleeding as a Source of Preventable Paralysis

As has been recognized for many years in the medical community, post-operative bleeding around the spinal cord following spine surgery can cause preventable paralysis. Postop monitoring in this patient population is directed in part to timely identifying when this complication is occurring and directing appropriate interventions to maintain the integrity of spinal cord function. The mechanism of injury is pressure from pooling blood against the spinal cord causing disruption of oxygen and nutrients to the spinal cord tissues. Damage can be permanent given enough pressure and time. Therapy is directed at relieving the pressure before permanent harm results.

In a recent study, researchers found that wide exposure of the epidural space and blood pressure levels plan an important role in development of this complication in anterior cervical spine surgeries. While this complication is rare, if it is not timely addressed the resulting damage to the spinal cord can be catastrophic. Appropriate therapy is removal of the blood surgically as quickly as practicable. Researchers also pointed out that spine surgery at multiple levels is an independent risk factor for post-operative bleeding around the spinal cord. They determined that blood pressure in the vascular supply surrounding the spinal cord is lower than that of the cerebrospinal fluid. But, when bleeding occurs the blood will pool until the pressure is equal to or greater than that of the cerebrospinal fluid. The authors posit that bleeding from arterial sources may lead to more damage to the spinal cord than that of venous sources and recommend swift diagnosis and treatment to prevent permanent paralysis.

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The Girards Law Firm represents people who have been paralyzed when post-operative bleeding complications are not timely diagnosed and treated.

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