Degenerative Disk Disease

Risk factors determined by spinal level

Cervical spine: C3 and C4 most common; 10% of degenerative disk disease

Thoracic: uncommon; can be related to trauma or tumor; 0.2–1.8% of disk disease

Lumbar; very common; 85–90% of disk disease; third most common cause of chronic pain in USA

Difficult airway

Spinal cord injury from airway manipulation or positioning

Positioning injury from prone position

Ischemic optic neuropathy

Cervical spine instability, nerve root entrapment, or chronic subluxation.

Difficulty with intubation.

Injury to the spinal cord, nerve roots.

Pressure injuries or ventilatory difficulty with the prone position.

Brachial plexus injury with the prone position.

Optimum perfusion to the head. Ischemia, neck position, or venous congestion may contribute to ischemic optic neuropathy.

Airway edema at the conclusion of surgery.

Pain from herniation of an intervertebral disk with nerve root compression is the third most common chronic disease in USA and the most common indication for elective spine surgery.

Incidence varies among spinal segments, being absent in sacral area; most common in lumbar area, next in cervical region, and uncommon in thoracic region.

Osteoarthritis

Trauma

Connective tissue diseases, such as rheumatoid arthritis or ankylosing spondylitis