الفهرس 
ANATOMY OF THE VERTEBRAL COLUMNOnly 14 pages are availabe for public view
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Abstract
The vertebral column forms the central axis of skeleton and it gives great protection to the spinal cord from any trauma.
The pathological conditions affecting the vertebral column may be traumatic, congenital, degenerative or tumorswhether benign or malignant.
Scoliosis may affect cervical, thoracic or lumbar regions. Complicated cases of scoliosis may affect pulmonary function as restrictive pattern of ventilation with the greatest affection occurring in vital capacity, chest wall compliance with increased pulmonary vascular resistance, pulmonary hypertension, right atrial enlargement and /or right ventricular enlargement.
Scoliotic patients are more vulnerable to malignant hyperthermia than general population and preoperative visit and evaluation is mandatory.
Oral flurazepam to allay anxiety at night before surgery and antisialagogue drugs as glycopyrrolate I.M. before surgery is desired.
Four classical positionsare used in spine surgery; which are: supine, prone, lateral and sittingposition. Basic monitoring include electrocardiogram,body temperature measurement, peripheral nerve stimulator, CVP, pulse oximetry, capnogram, direct measurement of arterial blood pressure especially if deliberate hypotension is required,somatosensory and motor evoked potential.
Difficult intubation is not uncommon so complete set of different size tubes, laryngoscope and other aids should be available. The best anesthetic combination is by narcotic, muscle relaxant, O2, and inhalational anesthetics.
Major problems which may be met during spinal surgery includes major blood loss, hypotension, hypothermia and catastrophic malignant hyperthermia (M.H), which should be early identified by hyperthermia,tachypnea, cardiac dysrhythmia and hypotension.The golden drugof M.H is dantrolene with cessation of inhalational anesthesia and change of whole anesthetic machine.Hypotension is the most common problem encountered in the immediate post operative period and should be early recognized and treated by blood and its substitutes, plasma expanders and fluid resuscitation.
Well prepared recovery room and well trained nurse should be available in the immediate postoperative period.