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Lumbar spine surgery positioning complications: a systematic review
Michael F Shriver1,2, Valerie Zeer1,2, Vincent J Alentado1,2
1Case Western Reserve University School of Medicine;
Neurosurgical Focus
|October 2, 2015
Summary
Patient positioning during dorsal lumbar spine surgery can lead to complications. This review highlights common issues like vision loss and provides recommendations to improve patient safety and reduce risks associated with surgical positions.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Surgical Safety
Background:
- Various surgical positions are used for dorsal lumbar spine exposure, including prone, knee-chest, and lateral decubitus.
- Each position carries unique risks of complications due to pressure on the torso or extremities.
Purpose of the Study:
- To systematically review clinical studies on complications associated with patient positioning during dorsal lumbar spine surgery.
- To identify evidence-based recommendations for avoiding these complications.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE, Scopus, and Web of Science.
- 34 studies meeting inclusion criteria were analyzed for reported complications, surgical positions, and operative factors.
Main Results:
- Vision loss was the most frequent complication in prone and knee-chest positions.
- Other reported complications include nerve palsies, thromboembolic events, and pressure sores.
- Increased operative time correlated with higher complication rates in the prone position.
Conclusions:
- Patient positioning in lumbar spine surgery is associated with a range of potential complications.
- Understanding these risks and implementing evidence-based strategies can enhance surgical team education and reduce complication rates.
