Ischemic optic neuropathy following spine surgery

Ho, Van Thong; Newman, N. J.; Song, Sun Ok; Ksiazek, Susan; Roth, Steven

doi:10.1016/j.ajo.2005.03.006

Cited by 41 publications

(83 citation statements)

References 7 publications

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“…Muscles are relaxed under GA in the prone position, such that shoulder and cervical dislocations have been mentioned (2,27). In addition, optic neuropathy and blindness have been reported (8,10). However, we did not observe any neurological complication in GA patients in terms of intraoperative positioning.…”

Section: Discussioncontrasting

confidence: 42%

Lumbar microdiscectomy under spinal and general anesthesia: a comparative study

Dağıstan¹,

Ökmen²,

Dağıstan³

et al. 2014

Turkish Neurosurgery

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AIm:To compare the safety and efficacy of spinal anesthesia (SA) in patients undergoing lumbar microdiscectomy (LM). mAterIAl and methOds:We evaluated 180 patients who underwent LM between 1 January 2012 and 5 July 2013. Demographic, clinical, laboratory, and pre-, intra-, and postoperative information was determined from the patients' medical records. results:Total anesthetic times were longer in the general anesthesia (GA) group. There was less bleeding at the surgical site in the SA group. Intraoperative blood pressure was significantly also lower in the SA group. Meanwhile, tachycardia was significantly higher in the GA group. The analgesic requirement in post-anesthesia care unit (PACU) was higher in the general anesthesia group. At PACU admission, analgesic requirement, heart rate, and the mean arterial pressure were higher in the GA group. Postoperative nausea and vomiting was more frequent among patients recovering in general anesthesia group. SA patients had an increased incidence of urinary retention compared with GA patients. Pulmonary complications requiring specific treatment were insignificantly higher among GA patients. COnClusIOn:In patients who undergo lumbar disc surgery, SA is a good alternative for experienced surgeons because of a more comfortable healing process.

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Section: Discussioncontrasting

confidence: 42%

Lumbar microdiscectomy under spinal and general anesthesia: a comparative study

Dağıstan¹,

Ökmen²,

Dağıstan³

et al. 2014

Turkish Neurosurgery

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“…48 61 101 AION has been more frequently reported after cardiac surgery. Visual loss was typically within the first 24 -48 h, frequently noted when the patient awoke after surgery.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Perioperative visual loss: what do we know, what can we do?

Roth¹

2009

British Journal of Anaesthesia

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255

116

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Perioperative visual loss (POVL), a rare, but devastating complication, can follow non-ocular surgery. Highest rates of visual loss are with cardiac and spine surgery. The main causes of visual loss after non-ocular surgery are retinal vascular occlusion and ischaemic optic neuropathy. This review updates readers on the incidence, suspected risk factors, diagnosis, and treatment of POVL due to these conditions. Br J Anaesth 2009; 103 (Suppl. 1): i31-i40Keywords: complications, neurological; complications, neuropathy; eye, intraocular pressure; eye, pupil; surgery, spinal Visual loss after anaesthesia and surgery is a rare, unexpected, and devastating complication. Clinicians have suspected that incidence is increasing, particularly with spinal fusion surgery; however, recent data suggest that this may not be the case. This review will update readers on the incidence, suspected risk factors, diagnosis, and treatment of perioperative visual loss (POVL), in the setting of non-ocular surgery. The causes of POVL are primarily retinal vascular occlusion (RVO) and ischaemic optic neuropathy (ION). The relevant anatomy of the ocular circulation has been reviewed elsewhere and is summarized in Figure 1. 80 Other sources are glycine toxicity during transurethral resection of the prostate, acute angle closure glaucoma, cortical blindness, and expansion of an intraocular sulphur hexafluoride vitrectomy bubble by administration of nitrous oxide. As these are less common, the reader is referred for details to a recent more inclusive review. 80

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“…36,41,44 Preoperative risk factors include obesity, peripheral vascular disease, hypertension, smoking, atherosclerosis, hyperlipidemia, diabetes hypercoagulability, sleep apnea, polycythemia, renal f a i l u r e , m a l e g e n d e r, a n d m i d d l e a g e group. 13,35,37,41À43,46 Direct pressure from the head rest on orbits may be higher in patients with low nasal bridges or exophthalmos.…”

Section: Risk Factorsmentioning

confidence: 99%

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

Kwee

Rozen

2015

International Surgery

215

162

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Surgery in the prone position is often a necessity when access to posterior anatomic structures is required. However, many complications are known to be associated with this type of surgery, as physiologic changes occur with increased pressure to anterior structures. While several studies have discussed postoperative vision loss, much fewer studies with lower levels of evidence have addressed other complications. A systematic literature review was conducted using 2 different databases, and 53 papers were regarded as appropriate for inclusion. Qualitative and quantitative analysis was performed. Thirteen complications were identified. Postoperative vision loss and cardiovascular complications, including hypovolemia and cardiac arrest, had the most number of studies and highest level of evidence. Careful planning for optimal positioning, padding, timing, as well as increased vigilance are evidence-based recommendations where operative prone positioning is required.

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Ischemic optic neuropathy following spine surgery

Cited by 41 publications

References 7 publications

Lumbar microdiscectomy under spinal and general anesthesia: a comparative study

Lumbar microdiscectomy under spinal and general anesthesia: a comparative study

Perioperative visual loss: what do we know, what can we do?

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

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