Neurologic deficits after cervical laminectomy in the prone position

Area of Science:

• Neurosurgery
• Spinal Cord Physiology

Background:

• New neurologic deficits can occur following spine surgery.
• Cervical myeloradiculopathy patients undergoing laminectomy/fusion in prone position are at risk.

Observation:

• Four patients developed new neurologic deficits after prone cervical surgery with chest roll support.
• Hypotension occurred transiently during surgeries.
• Post-anesthesia recovery revealed new deficits, though imaging and re-exploration were normal.

Findings:

• Prone positioning with abdominal compression may compromise spinal cord perfusion.
• This compromise can lead to spinal cord ischemia and subsequent neurologic deficits.

Implications:

• Utilizing frames to prevent abdominal compression is vital.
• Maintaining adequate perioperative arterial blood pressure is essential for spinal cord perfusion during and after surgery.