Spinal surgery positioning

1. Positioning for spinal
surgery
Upper Chesapeake medical center spine conference
Friday November 3rd, 2017

4. Be careful with cervical patients

21. (E. TRENT) ANDREWS table OSI Orthopaedic Systems Inc from Hayward California
1980

22. Spinal Surgery Table 1992 OSI
Dr. Roger P. Jackson, has practiced at North Kansas City, Missouri late 1980’s

24. In 2002, OSI was acquired by Mizuho Ikakogyo Co., Ltd., in Tokyo, Japan

28. Superman prone surrender position

35. Brachial plexus
injury
compression and
stretch
shoulder
abduction
greater than 90
degrees
external rotation
arm,

37. Risk factors for ulnar neuropathy: htn,
smoking, men (70%), DM, age, hypovolemia, hypoxia, hypothermia

38. Cubital tunnel pressure lowest in supination and
extension and highest in pronation and flexion

39. Optic n perfusion
1. Vascular tone
2. MAP
3. IOP: increases with T berg

40. POVL: post operative visual loss
• <1:500 cases
• Direct trauma
• Ischemic optic neuropathy
• Central retina artery occlusion
• 72% men, 84% >6 hours operative time, EBL>1 liter,
mean operative time 9.8 hours *, median onset time 15
hours,
• IOP increases dramatically with trendelenberg position
*Lee LA, Roth S, Posner KL, Cheney FW, Caplan RA, Newman NJ, Domino KB. The American
Society of Anesthesiologists Postoperative Visual Loss Registry: analysis of 93 spine surgery
cases with postoperative visual loss. Anesthesiology. 2006;105:652–69; quiz 867-868.

51. thanks