Positioning on surgical table

Schonauer, Claudio; Bocchetti, Antonio; Barbagallo, Giuseppe; Albanese, Vincenzo; Moraci, A

doi:10.1007/s00586-004-0728-y

Cited by 68 publications

(41 citation statements)

References 29 publications

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“…7 This in turn decreases venous return and cardiac output. 4 Increased intra-abdominal pressure may cause a decrease in renal perfusion and impair function, however, this is controversial. 7 Prone position also increases intraocular pressure as the episcleral venous system is connected to the central venous system by valveless vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Lateral femoral cutaneous nerve neuropathy in 20% of spinal surgery cases causing pain and dysesthesia in the anterolateral thigh. 4 Inappropriate pressure on vital structures of the abdomen can cause ischemia and organ failure, resulting in prolonged hospitalization, permanent disability, or death. 5 Cardiovascular changes associated with prone surgery increase risk of intraoperative cardiac arrest.…”

mentioning

confidence: 99%

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The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

Kwee

Rozen

2015

International Surgery

208

184

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Surgery in the prone position is often a necessity when access to posterior anatomic structures is required. However, many complications are known to be associated with this type of surgery, as physiologic changes occur with increased pressure to anterior structures. While several studies have discussed postoperative vision loss, much fewer studies with lower levels of evidence have addressed other complications. A systematic literature review was conducted using 2 different databases, and 53 papers were regarded as appropriate for inclusion. Qualitative and quantitative analysis was performed. Thirteen complications were identified. Postoperative vision loss and cardiovascular complications, including hypovolemia and cardiac arrest, had the most number of studies and highest level of evidence. Careful planning for optimal positioning, padding, timing, as well as increased vigilance are evidence-based recommendations where operative prone positioning is required.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

Kwee

Rozen

2015

International Surgery

208

184

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“…This frame allows for a free abdomen, but can potentially hyperextend the vertebral column [3] . The Andrews and the Wilson frames were both designed for prone lumbar spine surgery (Figure 1).…”

Section: Hemodynamic Complicationsmentioning

confidence: 99%

“…The degree of curvature of the bolsters is adjustable, which also allows the surgeon to alter the patient's lumbar sagittal plane alignment. The C-arm fluoroscopy machine can be integrated with both frames, with the Wilson frame providing a full 360 degrees of radiolucency when placed on the Jackson table [3] . The Jackson table also offers complete axial rotation capability for combined approaches.…”

Section: Hemodynamic Complicationsmentioning

confidence: 99%

Complications associated with prone positioning in elective spinal surgery

DePasse

Palumbo

Haque

et al. 2015

WJO

200

117

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Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity. Core tip: This review addresses the complications of prone positioning for spine surgery, which is an important and relatively underrepresented topic in the literature. Here, we address the wide range of complications by system, covering the most common complications, current understanding of pathophysiology, and strategies for prevention. Individual cases of very rare complications are also addressed. This article provides increased awareness and understanding of the risks of prone positioning, which is important for patient morbidity.

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“…Fifth, preoperative knowledge of a patient's ability to tolerate the prone position is an elementary to success in pain relief with PV for spine compression patients. Furthermore, it is wiser of us to use the customized spine table which is concave on abdomen contact area to reduce the abdominal pressure and to less likely develop the Valsalva maneuver 12) . In the clinical practice of PV, the 3D-CTA and/or MRA could be an effective and simple neuroimaging tools for screening the intracranial aneurysm in the PV candidates who are more likely to have it.…”

mentioning

confidence: 99%

Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

Lim

Park

Kim

2009

J Korean Neurosurg Soc

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On rare occasions, percutaneous vertebroplasty (PV) may be associated with adverse spinal and extraspinal events. Subarachnoid hemorrhage (SAH) has not been reported complication following a PV. This is a report of two elderly women with spine compressions who developed idiopathic SAH after injecting polymethylmethacrylate into the thoracolumbar region transcutaneously. PV was performed as an usual manner on prone position under local anesthesia for these patients. During the interventions, two patients complained of a bursting nature of headache and their arterial blood pressure was jumped up. Computed tomography scans revealed symmetric SAH on the both hemispheres and moderate degree of hydrocephalus. Any intracranial vascular abnormalities for their SAH were not evident on modern neuroangiography modalities. One patient received a ventricular shunt surgery, but both fully recovered from the procedure-related SAH. The pathophysiologic mechanism that induce SAH will be discussed, with suggesting the manner that prevent and minimize this rare intracranial complication after PV.

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Positioning on surgical table

Cited by 68 publications

References 29 publications

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

Complications associated with prone positioning in elective spinal surgery

Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

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