Sudden hemodynamic collapse after prone positioning on a Jackson spinal table for spinal surgery

Area of Science:

• Anesthesiology
• Cardiovascular Physiology
• Surgical Positioning

Background:

• Prone positioning is common in surgeries, but can lead to hypotension.
• Hemodynamic instability is a recognized risk during prone procedures.

Observation:

• A patient undergoing lumbar fusion experienced sudden, severe hypotension and circulatory collapse upon prone positioning on a Jackson spinal table.
• Standard treatments like fluid expansion and vasopressors were ineffective.

Findings:

• External abdominal support was applied, immediately restoring hemodynamic stability.
• The patient completed surgery successfully without complications, including abdominal compartment syndrome.

Implications:

• The Jackson spinal table may cause abdominal sagging, leading to inferior vena cava (IVC) kinking or venous pooling.
• External abdominal support can counteract these effects, preventing venous return obstruction.
• This highlights the importance of considering abdominal support in prone surgeries to manage potential hemodynamic complications.