Anesthetic consideration on myeloradiculopathy patient undergoing anterior cervicosternotomy

Abstract

Myeloradiculopathy, a condition that involves the spinal cord and spinal nerve roots, is the major cause of disability patients. Most patients with myeloradiculopathy receive surgical intervention with the aim of removing the underlying compression injury from the nerve, decompressing the cord, and moving it without friction or further damage. Surgery on the spine and spinal cord has broadened its scope in recent years. The anterior approach is a challenging procedure given the various vascular, osseous, nervous, and articular structures that prevent adequate exposure and the potential damage to anesthetists. Our objective was to evaluate the pre-operative analysis, maintenance during intra-operative care, and post-operative care in patients with myeloradiculopathy undergoing posterior stabilization surgery with an anterior approach (cervicosternotomy). A 23-year-old woman was diagnosed with Myeloradiculopathy at Th2 Vertebrae Level due to space-occupying extradural lesion at Th2-Th4 vertebral level with pathological fracture at Thoracal Th2 et Th7 et Th10 due to suspected spondylitis tuberculosis with paravertebral abscess, with ASA I (Physical Status Classification System). The patient was then treated with laminectomy debridement, abscess drainage, and posterior stabilization through a cervicothoracic spine surgery with an anterior approach. The patient received the preoperative assessment, intraoperative maintenance, and postoperative evaluations, which  are very important to ensure a good outcome of the cervicosternotomy with an anterior approach.

DOI : 10.35990/amhs.v2n2.p88-95

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