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A Technique to Allow Prone Positioning in the Spine Surgery Patient With Unstable Spine Fracture and Flail Segment
Matthew W Pennington1, Anthony M Roche, Richard J Bransford
1From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
Abstract:
Two patients with unstable thoracic spine and flail segment rib fractures initially failed prone positioning on a Jackson spinal table used for posterior spinal instrumentation and fusion surgery. Both patients experienced rapid hemodynamic collapse. We developed a solution using the anterior portions of a thoracolumbosacral orthosis brace as chest supports to use during prone positioning, allowing both patients to undergo uncomplicated posterior spinal instrumentation and fusion surgeries with greater hemodynamic stability.
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Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
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The pathophysiology of flail chest is complex, involving fractures of...
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The body is upright, facing forward, and standing erect.
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