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Central retinal artery occlusion after spinal surgery

J Sys1, J Michielsen, E Mertens

  • 1Department of Orthopaedic Surgery, University Hospital of Antwerp, Belgium.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|January 1, 1996
PubMed
Summary

Excessive pressure on the eye during surgery can cause central retinal artery occlusion, a rare complication after spinal procedures. This case highlights the risk following posterior lumbar spinal fusion using a specific headrest.

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Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Anesthesiology

Background:

  • Central retinal artery occlusion (CRAO) is a severe visual impairment.
  • Surgical procedures, particularly those involving prolonged positioning, carry risks of ocular complications.
  • Excessive extrinsic pressure on the eyeball is a known, albeit rare, cause of CRAO.

Observation:

  • A case of CRAO occurred in an adult patient post-elective posterior lumbar spinal fusion.
  • A rectangular headrest was utilized during the surgical procedure.
  • The occlusion was identified as central retinal artery occlusion.

Findings:

  • The patient developed CRAO following posterior lumbar spinal fusion.
  • The use of a rectangular headrest during spinal surgery was associated with the complication.

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  • This suggests a potential link between surgical positioning and CRAO in this context.

    • Implications:

    • Highlights the importance of vigilant monitoring for ocular complications during and after spinal surgery.
    • Suggests a need to evaluate headrest design and patient positioning techniques to mitigate risks of CRAO.
    • Emphasizes the critical role of anesthesiologists and surgeons in preventing iatrogenic visual loss.