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Neurosurg Focus ; 33(2): E14, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22853832

RESUMO

Postoperative visual loss (POVL) after spine surgery performed with the patient prone is a rare but devastating postoperative complication. The incidence and the mechanisms of visual loss after surgery are difficult to determine. The 4 recognized causes of POVL are ischemic optic neuropathy (approximately 89%), central retinal artery occlusion (approximately 11%), cortical infarction, and external ocular injury. There are very limited guidelines or protocols on the perioperative practice for "prone-position" surgeries. However, new devices have been designed to prevent mechanical ocular compression during prone-position spine surgeries. The authors used PubMed to perform a literature search for devices used in prone-position spine surgeries. A total of 7 devices was found; the authors explored these devices' features, advantages, and disadvantages. The cause of POVL seems to be a multifactorial problem with unclear pathophysiological mechanisms. Therefore, ocular compression is a critical factor, and eliminating any obvious compression to the eye with these devices could possibly prevent this devastating perioperative complication.


Assuntos
Monitorização Intraoperatória/instrumentação , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Medula Espinal/cirurgia , Transtornos da Visão/prevenção & controle , Humanos , Complicações Pós-Operatórias/etiologia , Medula Espinal/patologia , Doenças da Coluna Vertebral/patologia , Doenças da Coluna Vertebral/cirurgia , Transtornos da Visão/etiologia
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