Does Conventional Practice Prevent Occular Complications in Prone Position Spinal Surgery?

Haushofer, Lisa; Bhattacharyya, Mayukh; Isibor, Rochester N; Sakka, S.

doi:10.1177/175045890901900101

Cited by 6 publications

(3 citation statements)

References 6 publications

(5 reference statements)

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“…20 Following considerations are recommended as prevention tools of POVL: (1) To identify and optimize preoperative risk factors including hypertension, diabetes, hypercoagulable states, smoking, anemia, collagen disorders, and explain the possibility of such a complication to high-risk patients. Simultaneously, we should inform and reassure patient of the reduced risk of such complication in spine surgery when sufficient preoperative precautionary measures are taken.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Visual Loss After Spine Surgery

Nabiuni¹,

Sarvarian

2014

Neurosurgery Quarterly

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Postoperative visual loss subsequent spine surgery is a rare but devastating complication with an estimated rate varying between 0.05% and 1.0%. However ischemic optic neuropathy, central artery thrombosis, and cortical blindness have been mentioned as recognized causes of postoperative visual loss, the exact etiologies are still unclear. The patient was a 58-year-old diabetic woman referred to our department with sudden visual loss, ophthalmoplegia, periorbital edema, and ptosis eyelid in her left eye 1 day after surgery for spinal spondylolisthesis. She mentioned the past medical history of rhinosinusitis and polyps. She did not smoke or drink alcohol.

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Section: Discussionmentioning

confidence: 99%

Postoperative Visual Loss After Spine Surgery

Nabiuni¹,

Sarvarian

2014

Neurosurgery Quarterly

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“…Desde el punto de vista médico-legal, caben algunas consideraciones de importancia: En primer lugar es preciso indicar que esta entidad (ceguera tras cirugía discal lumbar) es de diagnóstico difícil y de prevención también dificultosa. Los análisis de casos con eventual responsabilidad médica deben asegurar que se han tomado todas las medidas posicionales y de protección ocular apropiadas al caso [64]. También deben indagar sobre las causas generales capaces de producir alteraciones visuales, y conocer si en su prevención o manejo se tomaron las debidas precauciones y se adoptó el tratamiento apropiado.…”

Section: Discussionunclassified

Ceguera tras cirugía discal lumbar: Aspectos asistenciales y médico-legales. Presentación de un caso y revisión de la Literatura

Aso¹,

Martínez-Quiñones²,

Ara³

et al. 2009

Cuad. med. forense

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Servicio de Radiodiagnóstico. Hospital MAZ. RESUMEN Entre las complicaciones de la cirugía discal lumbar, una, poco frecuente pero especialmente incapacitante es la ceguera. Presentamos un caso de ceguera cortical transitoria tras una microcirugía discal convencional L5-S1 en una paciente sana. Se discuten las posibles causas propuestas por la literatura, y se propone el embolismo gaseoso como origen probable de la ceguera cortical experimentada por la paciente. Al tratarse de una complicación de diagnóstico difícil, pero con cierto grado de posibilidad de prevención, y de tratamiento eficaz, se analizan también los principales problemas médico-legales tanto relativos al análisis de mala praxis como a cuestiones relacionadas con el consentimiento informado. Palabras clave: Cirugía discal; complicaciones quirúrgicas; ceguera; mala praxis; consentimiento informado: embolismo gaseoso; Neuropatías óptica isquémica; Ceguera cortical.

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“…After the patient has been rolled over into the prone position, the anesthesiologist ensures the correct position of the device headrest. 5 Although this device has been created to protect the patient's eyes against any unintentional contact, compressive injuries have been reported when it is used in conjunction with foam headrests. The injuries can occur when the OPTI-GARD plastic lens is loosened and/or compressed, resulting in a higher probability of inadvertent eye compression.…”

Section: Opti-gard Eye Protectormentioning

confidence: 99%

Current intraoperative devices to reduce visual loss after spine surgery

Baig

Puente²,

Viloria³

et al. 2012

FOC

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Postoperative visual loss (POVL) after spine surgery performed with the patient prone is a rare but devastating postoperative complication. The incidence and the mechanisms of visual loss after surgery are difficult to determine. The 4 recognized causes of POVL are ischemic optic neuropathy (approximately 89%), central retinal artery occlusion (approximately 11%), cortical infarction, and external ocular injury. There are very limited guidelines or protocols on the perioperative practice for “prone-position” surgeries. However, new devices have been designed to prevent mechanical ocular compression during prone-position spine surgeries. The authors used PubMed to perform a literature search for devices used in prone-position spine surgeries. A total of 7 devices was found; the authors explored these devices' features, advantages, and disadvantages. The cause of POVL seems to be a multifactorial problem with unclear pathophysiological mechanisms. Therefore, ocular compression is a critical factor, and eliminating any obvious compression to the eye with these devices could possibly prevent this devastating perioperative complication.

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Does Conventional Practice Prevent Occular Complications in Prone Position Spinal Surgery?

Cited by 6 publications

References 6 publications

Postoperative Visual Loss After Spine Surgery

Postoperative Visual Loss After Spine Surgery

Ceguera tras cirugía discal lumbar: Aspectos asistenciales y médico-legales. Presentación de un caso y revisión de la Literatura

Current intraoperative devices to reduce visual loss after spine surgery

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