[Comparative studies of patient positioning for lumbar intervertebral disk operation]

Area of Science:

• Neurosurgery
• Anesthesiology
• Cardiovascular Physiology

Background:

• Posterior lumbar disk surgery requires specific patient positioning.
• The Wilson frame and genupectoral position are common choices.
• Hemodynamic stability during these positions is critical.

Purpose of the Study:

• To prospectively evaluate hemodynamic changes associated with patient positioning during posterior lumbar disk surgery.
• To compare the effects of the Wilson frame versus the genupectoral position on mean arterial pressure (MAP) and heart rate (HR).

Main Methods:

• 80 neurosurgical patients undergoing lumbar disk surgery were randomized into two groups: Wilson frame (Group I) and genupectoral position (Group II).
• Patients received either total intravenous anesthesia or balanced anesthesia.
• Hemodynamic parameters (MAP and HR) were recorded at three time points: post-induction, pre-redirection, and post-redirection.

Main Results:

• Anesthesia induction did not significantly decrease MAP.
• The Wilson frame group showed no significant changes in MAP or HR post-positioning.
• The genupectoral position group exhibited significant decreases in MAP (p < 0.001) and HR (p = 0.016).

Conclusions:

• The Wilson frame is recommended for neurosurgical lumbar disk surgery, especially in patients with cardiovascular or cerebrovascular disorders, due to its hemodynamic stability.
• The genupectoral position can lead to significant hemodynamic compromise.
• Further research into anesthetic effects on hemodynamics in prone positions is warranted.