Related Experiment Videos
Ischaemic optic neuropathy after spinal fusion
J A Dilger1, J E Tetzlaff, G R Bell
1Department of General Anesthesiology, Cleveland Clinic Foundation, Ohio 44195, USA. Dilgerj-cesmtp.ccf.org
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|February 18, 1998
Summary
Prolonged prone positioning during spine surgery may cause vision loss due to venous engorgement. This case highlights a potential risk of ischaemic optic neuropathy in obese, diabetic patients after lengthy procedures.
Area of Science:
- Ophthalmology
- Neurosurgery
- Anesthesiology
Background:
- Ischaemic optic neuropathy (ION) is a serious complication that can occur after surgery.
- Obesity and diabetes are known risk factors for vascular complications.
Observation:
- A 44-year-old obese, diabetic male developed bilateral ION after a prolonged lumbar spine surgery in the prone position.
- Postoperative visual decline was noted, with examination revealing optic swelling and visual acuity deficits.
- Magnetic resonance imaging (MRI) of the head and orbits showed no other abnormalities.
Findings:
- The patient's ION was attributed to prolonged prone positioning on a Relton-Hall frame.
- Venous engorgement secondary to the surgical position is the suspected cause of the ischaemic event.
- Conservative treatment led to significant visual improvement within 47 days.
Implications:
- Surgeons and anesthesiologists should be aware of the risk of ION in patients undergoing prolonged prone spine surgery.
- Careful patient positioning and monitoring may help mitigate the risk of this vision-threatening complication.
- Further research is warranted to elucidate the exact mechanisms and preventative strategies for ION in this surgical context.