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Updated: Jan 11, 2026

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The Sitting Position in Neurosurgery: Is it Safe?

Ali Şahin1, Nimetullah Alper Durmuş1, Şükrü Oral1

  • 1Department of Neurosurgery, Erciyes University Faculty of Medicine, Kayseri, Türkiye.

Journal of Clinical Practice and Research
|November 19, 2025
PubMed
Summary

The sitting position is safe for cerebellopontine angle tumor surgery but poses risks for cerebellar tumors, especially with patent foramen ovale or emergency procedures. Careful patient selection is crucial for neurosurgery safety.

Keywords:
Air embolismneurosurgeryposteriorsitting positionvenous

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Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Surgical Positioning

Background:

  • The sitting position offers surgical advantages but carries potential risks.
  • Understanding these risks is crucial for patient safety in neurosurgery.

Purpose of the Study:

  • To analyze the safety and efficacy of the sitting position in neurosurgery.
  • To identify specific patient groups at higher risk for complications.

Main Methods:

  • Retrospective review of 73 patients who underwent surgery in the sitting position.
  • Analysis of patient demographics, diagnoses, and surgical/anesthetic factors.

Main Results:

  • Venous air embolism (VAE) occurred in 15.1% of patients.
  • VAE rates were higher in patients with cerebellar tumors, patent foramen ovale (PFO) on transesophageal echocardiography (TEE), and prolonged/emergency surgeries.
  • Tension pneumocephalus and other postoperative complications were also noted.

Conclusions:

  • The sitting position is suitable for cerebellopontine angle tumor surgery.
  • Caution is advised for patients with cerebellar tumors, PFO, or those undergoing emergency procedures due to increased VAE risk.