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World J Orthop. Oct 18, 2012; 3(10): 156-161
Published online Oct 18, 2012. doi: 10.5312/wjo.v3.i10.156
Pulmonary complications after spine surgery
Ottokar Stundner, Fadi Taher, Abhijit Pawar, Stavros G Memtsoudis
Ottokar Stundner, Stavros G Memtsoudis, Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, United States
Fadi Taher, Abhijit Pawar, Department of Spine Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, United States
Author contributions: All the authors contributed to conception and design of data/review material, drafting and/or critically revising the article, and final approval of the version of be published.
Correspondence to: Stavros G Memtsoudis, MD, PhD, Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, United States. memtsoudisS@hss.edu
Telephone: +1-212-6061206 Fax: +1-212-5174481
Received: March 15, 2012
Revised: September 21, 2012
Accepted: October 10, 2012
Published online: October 18, 2012
Abstract

Spine surgery is one of the fastest growing branches of orthopedic surgery. Patients often present with a relatively high acuity and, depending on surgical approach, morbidity and mortality can be comparatively high. Among the most prevalent and most frequently fatality-bound perioperative complications are those affecting the pulmonary system; evidence of clinical or subclinical lung injury triggered by spine surgical procedures is emerging. Increasing burden of comorbidity among the patient population further increases the likelihood of adverse outcome. This review is intended to give an overview over some of the most important causes of pulmonary complications after spine surgery, their pathophysiology and possible ways to reduce harm associated with those conditions. We discuss factors surrounding surgical trauma, timing of surgery, bone marrow and debris embolization, transfusion associated lung injury, and ventilator associated lung injury.

Keywords: Spine surgery; Complications; Pulmonary; Pulmonary embolism; Transfusion-associated lung injury; Ventilator-associated lung injury