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Postoperative vision loss after spine surgery: a single-institution case-control comparison
Ehab Farag1, Alaa A Abd-Elsayed2, Jarrod E Dalton3
1Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH ; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH.
Ochsner Journal
|June 19, 2014
Summary
Postoperative vision loss (POVL) after spine surgery is linked to increased blood loss and red blood cell transfusions. This case-control study highlights these critical factors in POVL development.
Area of Science:
- Ophthalmology
- Neurosurgery
- Anesthesiology
Background:
- Postoperative vision loss (POVL) is a rare yet severe complication following spine surgery.
- This study investigates POVL, specifically ischemic optic neuropathy or central vision loss, after complex spine procedures.
Purpose of the Study:
- To identify risk factors associated with postoperative vision loss after complex spine surgery.
- To compare intraoperative measures between patients who developed POVL and matched controls.
Main Methods:
- Retrospective case-control study of POVL cases from December 1995 to December 2010.
- Matching POVL cases with 5 controls based on demographics and hemodynamic parameters.
- Comparison of intraoperative data including blood loss and red blood cell transfusion volumes using Wilcoxon rank sum test.
Main Results:
- Six patients developed POVL.
- POVL cases exhibited significantly greater blood loss (P=0.002) and red blood cell transfusions (P=0.006) compared to controls.
- No other intraoperative measures showed significant differences after Bonferroni correction.
Conclusions:
- Increased blood loss and greater red blood cell transfusion volumes are significantly associated with POVL after complex spine surgery.
- These findings underscore the importance of managing blood loss during extensive spinal procedures.
