Komplikace z pronační polohy při spondylochirurgických výkonech

Title in English Complications from the prone position during spine surgery


Year of publication 2019
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Description The patient's position on the operating table is key to preventing complications from the pronation position. This is a non-physiological situation which, in relation to the type and duration of the procedure, in combination with the patient's existing comorbidities can lead to a variety of temporary or persistent complications. They are very rare and can lead to invalidity of varying degrees. Complications from the pronation position make it possible to clearly divide them into hemodynamic, neurological, ophthalmological, skin-muscle complications. Ophthalmic complications such as vision loss or amaurosis are well described and remain very rare. Neurological complications such as isolated injuries to peripheral nerves, especially of the upper limbs or various degrees of paresis of the brachial plexus, are also rare, but are seen in the postoperative period and should be prevented. To do this, choose especially the extended traction of the plexus in predisposed individuals. Skin-muscle complications such as pressure ulcers, compartment syndrome are rare. Hemodynamic complications in imperfect positions of obese patients are discussed, for example, by the compression of the inferior vena cava and the secondary stagnation of blood in the paravertebral and epidural vessels, leading to higher blood loss and decreased orientation in the surgical field. Occlusions of the femoral artery and avascular necrosis of the femoral head are described. By understanding the variety and the mechanism of these rare complications from the pronation position, they can be elegantly prevented. The aim of this work is to draw attention to complications and outline possible procedures for their minimization.

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