Background: Near infrared spectroscopy (NIRS) devices like cerebral oximeters have lately gained their actuality in different medical fields. Used intraoperative they can early detect harmful event and gives a possibility to avoid from further brain damage. The goal of the study was to determine whether prone position during spinal neurosurgery impacts cerebral oxygen saturation using NIRS. Material and methods: 28 patients (mean age 56±12.5y) underwent spinal neurosurgery in prone position (transpedicular fixation (TPF) = 15, micro discectomy (MDE) = 8, spinal tumor removal (spinal Tu) = 5). Cerebral oxygen saturation (rScO2) was continuously monitored using INVOS 4100 cerebral oximeter. We also assessed blood loss, postoperative complications (stroke, organ dysfunction, wound infection, days spent in ICU) and cognitive dysfunction using MoCA Montreal - Cognitive Assessment scale. All patients received standard general anaesthesia. All patients were extubated in the operating room. Results: Significant changes in calculated mean rScO2 values between supine and prone position during the surgery were not observed. Mean rScO2 during the whole surgery was 73% above the right cerebral hemisphere (R), 73% above the left (L). Lying supine during induction R72%, L71%, in prone position R74%, L74%, returning back to spinal position R73%, L73%. 11 out of 28 patients showed a slight to significant decrease in rScO2 values in prone position. One patient showed a rScO2 decrease by 27% from baseline value. Average blood loss was 308ml. Average duration of operation was 110min. No incidence of stroke, organ dysfunction was observed. One patient was admitted to ICU due to blood loss. One patient showed cognitive dysfunction.
Cerebral Oxygenation Changes Observed in Patients Undergoing Spinal Neurosurgery in Prone Position Using Near Infrared Spectroscopy
