Neurologic deficits after cervical laminectomy in the prone position

Anish Bhardwaj, Donlin M. Long, Thomas B. Ducker, Thomas J K Toung

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

New neurologic deficits are known to occur after spine surgery. We present four patients with cervical myeloradiculopathy who underwent cervical laminectomy, fusion, or both in the prone position, supported by chest rolls. Three patients were intubated and positioned while awake, whereas the fourth patient was positioned after induction. Surgeries were successfully carried out, except for transient episodes of relative hypotension intraoperatively. On recovery from anesthesia, all patients were noted to have new neurologic deficits. Immediate CT myelography or surgical reexploration was unremarkable. All patients improved gradually with administration of high-dose steroids and induction of hypertension. Use of the prone position with abdominal compression may compromise spinal cord perfusion and lead to spinal cord ischemia. The use of frames that prevent abdominal compression, as well as avoidance of perioperative arterial hypotension, is important in maintaining adequate spinal cord perfusion during and after decompressive spinal cord surgery.

Original languageEnglish
Pages (from-to)314-319
Number of pages6
JournalJournal of Neurosurgical Anesthesiology
Volume13
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Prone Position
Laminectomy
Neurologic Manifestations
Spinal Cord
Hypotension
Perfusion
Spinal Cord Ischemia
Myelography
Spine
Thorax
Anesthesia
Steroids
Hypertension

Keywords

  • Cervical
  • Cord
  • Ischemia
  • Laminectomy
  • Myelopathy
  • Prone

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Neurologic deficits after cervical laminectomy in the prone position. / Bhardwaj, Anish; Long, Donlin M.; Ducker, Thomas B.; Toung, Thomas J K.

In: Journal of Neurosurgical Anesthesiology, Vol. 13, No. 4, 2001, p. 314-319.

Research output: Contribution to journalArticle

Bhardwaj, Anish ; Long, Donlin M. ; Ducker, Thomas B. ; Toung, Thomas J K. / Neurologic deficits after cervical laminectomy in the prone position. In: Journal of Neurosurgical Anesthesiology. 2001 ; Vol. 13, No. 4. pp. 314-319.
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