The ideal patient positioning in spine surgery: a preventive strategy

Abstract

Patient positioning on the surgical table is a critical step in every spine surgery. The most common surgical positions in spine surgery are supine, prone and lateral decubitus. There are countless lesions that can occur during spine surgery due to patient mispositioning. Ulnar nerve and brachial plexus injuries are the most common nerve lesions seen in malpositioned patients. Devastating complications due to increased intraocular pressure or excessive abdominal pressure can also occur in prone decubitus and are real concerns that the surgical team must be aware of. All members of the surgical team (including surgeons, anesthesiologists and nurses) should know how to correctly position the patient, identify possible positioning errors and know how to avoid them in order to prevent postoperative morbidity. This work pretends to do a review of the most common positions during spine surgery, alert to errors that can happen during the procedure and how to avoid them.

The Role of Anesthetic Techniques and Drugs in Laparotomy Cases of Postoperative Ileus

“…ASA 2 cases definition is a patient with mild systemic disease has comorbidity like mild asthma or well-controlled hypertension. There is no significant impact on daily activity; therefore, there is unlikely impact on anesthesia and surgery 11 . The importance of gra-ding the Patient with PS ASA correlates significantly linearly with 48-hour mortality, where a higher PS ASA stage increases the risk of 48hour mortality 17 .…”

“…An anesthesiologist should take a thorough examination for the pre-anesthesia visit. These should include a history taking, physical examination, diagnostic data review, PS ASA assignment, and a discussion regarding future anesthesia care 11 . Affirmative history is represented by the acronym A2, B2, C2, D2, E2, F2, and G2 in the pre-anesthetic check.…”

The Impact of Patient-Specific Positions on the Relationship between Iliac Blood Vessels and Lumbar Intervertebral Discs: Anatomical Significance and Clinical Implications

“…The research and discussion of every factor that has an impact on the decrease in the incidence of complications after spine surgery is important. The positioning of the patient during neurosurgical procedures has an important role in the avoidance of complications during spine surgery [17][18][19][20].…”

Comparison of head positioning using the Mayfield skull clamp versus padded headrest in anterior cervical discectomy and fusion surgery

“…Positioning for ACDF can be achieved using head fixation in the Mayfield skull clamp or a padded headrest ( 9 ). Whereas use of a padded headrest provides a fast and non-invasive method to position the patient’s head for ACDF surgery, it can also provide less stability to intraoperative manipulation.…”