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[Rhabdomyolysis after prolonged knee-chest position]
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1986
Summary
Prolonged knee-chest positioning during spondylolisthesis surgery can lead to rhabdomyolysis and acute kidney injury. Limiting this position to 3 hours may prevent these serious complications.
Area of Science:
- Neurosurgery
- Nephrology
- Orthopedic Surgery
Background:
- Spondylolisthesis surgery sometimes requires prolonged prone positioning.
- The knee-chest position is utilized in certain spinal surgeries.
Observation:
- Two patients undergoing spondylolisthesis surgery developed acute renal failure after prolonged knee-chest positioning (4.5-5.3 hours).
- Rhabdomyolysis was diagnosed via elevated creatine phosphokinase (CPK) and myoglobin levels.
- Muscle compression against surgical supports is the suspected cause.
Findings:
- Early diagnosis of rhabdomyolysis is crucial.
- Prompt fasciotomy and alkali administration are recommended treatments.
- Post-hemodialysis outcomes were positive.
Implications:
- The knee-chest position should be limited to a maximum of 3 hours to mitigate risks.
- This finding has significant implications for surgical positioning protocols in spinal procedures.
- Awareness and preventative measures are key to avoiding severe postoperative complications.