scholarly journals Assessment of Great Vessels for Anterior Access of L5/S1 Using Patient Positioning

2020 ◽  
Vol 14 (4) ◽  
pp. 438-444 ◽  
Author(s):  
John Choi ◽  
Isaac Rhee ◽  
Sameer Ruparel
Keyword(s):  
Patient Positioning ◽  
Population Group ◽  
Lateral Decubitus Position ◽  
Lumbosacral Region ◽  
Cross Sectional ◽  
Disk Space ◽  
Spinal Fusion Surgery ◽  
Mean Width ◽  
Great Vessels ◽  
Lateral Decubitus

Study Design: This was a prospective cross-sectional study.Purpose: The aim was to describe the effect of patient positioning, from supine to lateral decubitus position, on the width of the L5/S1 anterior disk space defined by the great vessels.Overview of Literature: The application of the lateral decubitus position interbody fusion has been rapidly increasing; however, there are concerns regarding the access to the lumbosacral region due to the great vessels, which necessitates further morphometric data.Methods: A total of 20 consecutive live patients awaiting lumbar surgery were subjected to two magnetic resonance imaging scans on the same day in both supine and lateral decubitus positions at a single center to investigate the anterior L5/S1 disk space.Results: The bare anterior L5/S1 disk window was present in all patients of this study population, and the mean width was 27 mm in the supine and 22 mm in the lateral decubitus position, with a mean reduction of 5.2 mm between the positions. The oblique corridor angle was measured at a mean of 33°.Conclusions: The bare window of L5/S1 disk space was present within this population group, and it was found to be mobile and changed significantly with patient positioning. Therefore, the spine surgeon or the access surgeon must consider the increased potential vascular risk during disk access in lateral decubitus anterior lumbar interbody spinal fusion surgery.

scholarly journals Quantifying the effect of biopsy lateral decubitus patient positioning compared to supine prostate MRI scanning on prostate translocation and distortion

2019 ◽  
Vol 14 (9) ◽  
Author(s):  
Ziga Snoj ◽  
Leonardo Rundo ◽  
Andrew B. Gill ◽  
Tristan Barrett
Keyword(s):  
Patient Positioning ◽  
Relative Volume ◽  
Lateral Decubitus Position ◽  
Lateral Direction ◽  
Positional Change ◽  
Institutional Review ◽  
Minimal Distortion ◽  
Lateral Decubitus ◽  
Moderate Negative Correlation ◽  
Correlation Trend

Introduction: More than a quarter of tumors are missed by magnetic resonance imaging/ultrasound (MRI/US) fusion-guided biopsy, the majority due to software-based misregistration. Transrectal approaches to biopsy are typically performed in the lateral decubitus position; conversely, diagnostic MRI is performed with the patient lying supine. Any position-related difference in prostate location or gland deformation could potentially exacerbate misregistration at subsequent biopsy. Methods: Fifteen healthy male volunteers (mean age 35.9 years, range 27–53) were included in this prospective, institutional review board-approved study. Each volunteer had an MRI performed in the supine position, followed by the second in the lateral decubitus position (mimicking a typical biopsy position). MRI images were co-registered and analyzed in order to assess prostate translocation and distortion. Results: Whole prostate translocation of ≥5 mm was observed in 20% of patients and ≥3 mm in 60% of patients. When dividing the prostate into prostatic sectors, the prostatic base demonstrated the largest positional difference. When plotting the translocation directions with relative volume difference, there was a moderate negative correlation trend in the latero-lateral direction. Only minimal distortion was observed, with similar distortion among all prostatic sectors. Conclusions: Positional change affects the prostate translocation, however, the effect on prostate distortion appears to be negligible. Prostate translocation in latero-lateral direction can be minimized with larger bladder volumes. Thereby, prostate translocation needs to be considered alongside software misregistration error; however, positional change should not affect software registration of MRI/US fusion-guided prostate biopsy.

Beach Chair Versus Lateral Decubitus Position: Differences in Suture Anchor Position and Number During Arthroscopic Anterior Shoulder Stabilization

2021 ◽  
pp. 036354652110137
Author(s):  
Jacqueline E. Baron ◽  
Kyle R. Duchman ◽  
Carolyn M. Hettrich ◽  
Natalie A. Glass ◽  
Shannon F. Ortiz ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Suture Anchor ◽  
Patient Positioning ◽  
Labral Tear ◽  
Anterior Shoulder Instability ◽  
Glenohumeral Instability ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Lateral Decubitus ◽  
Beach Chair

Background: Arthroscopic shoulder capsulolabral repair using glenoid-based suture anchor fixation provides consistently favorable outcomes for patients with anterior glenohumeral instability. To optimize outcomes, inferior anchor position, especially at the 6-o’clock position, has been emphasized. Proponents of both the beach-chair (BC) and lateral decubitus (LD) positions advocate that this anchor location can be consistently achieved in both positions. Hypothesis: Patient positioning would be associated with the surgeon-reported labral tear length, total number of anchors used, number of anchors in the inferior glenoid, and placement of an anchor at the 6-o’clock position. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study was a cross-sectional analysis of a prospective multicenter cohort of patients undergoing primary arthroscopic anterior capsulolabral repair. Patient positioning in the BC versus LD position was determined by the operating surgeon and was not randomized. At the time of operative intervention, surgeon-reported labral tear length, total anchor number, anchor number in the inferior glenoid, and anchor placement at the 6-o’clock position were evaluated between BC and LD cohorts. Descriptive statistics and between-group differences (continuous: t test [normal distributions], Wilcoxon rank sum test [nonnormal distributions], and chi-square test [categorical]) were assessed. Results: In total, 714 patients underwent arthroscopic anterior capsulolabral repair (BC vs LD, 406 [56.9%] vs 308 [43.1%]). The surgeon-reported labral tear length was greater for patients having surgery in the LD position (BC vs LD [mean ± SD], 123.5°± 49° vs 132.3°± 44°; P = .012). The LD position was associated with more anchors placed in the inferior glenoid and more frequent placement of anchors at the 6-o’clock (BC vs LD, 22.4% vs 51.6%; P < .001). The LD position was more frequently associated with utilization of ≥4 total anchors (BC vs LD, 33.5% vs 46.1%; P < .001). Conclusion: Surgeons utilizing the LD position for arthroscopic capsulolabral repair in patients with anterior shoulder instability more frequently placed anchors in the inferior glenoid and at the 6-o’clock position. Additionally, surgeon-reported labral tear length was longer when utilizing the LD position. These results suggest that patient positioning may influence the total number of anchors used, the number of anchors used in the inferior glenoid, and the frequency of anchor placement at the 6 o’clock position during arthroscopic capsulolabral repair for anterior shoulder instability. How these findings affect clinical outcomes warrants further study. Registration: NCT02075775 (ClinicalTrials.gov identifier)

Surgical Techniques for Thoracoscopic Esophagectomy at the Left Lateral Decubitus Position

2019 ◽  
Vol 70 (2) ◽  
pp. 197-197
Author(s):  
H. Sato ◽  
Y. Miyawaki ◽  
N. Fujiwara ◽  
H. Sugita ◽  
M. Aikawa ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Lateral Decubitus Position ◽  
Thoracoscopic Esophagectomy ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus

scholarly journals Changes in the Bronchial Cuff Pressure of Left-Sided Double-Lumen Endotracheal Tube by Lateral Positioning: A Prospective Observational Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1590
Author(s):  
Jong-Hae Kim ◽  
Eugene Kim ◽  
In-Young Kim ◽  
Eun-Joo Choi ◽  
Sung-Hye Byun
Keyword(s):  
Thoracic Surgery ◽  
Endotracheal Tube ◽  
Primary Outcome ◽  
Cuff Pressure ◽  
Lateral Decubitus Position ◽  
Double Lumen ◽  
Double Lumen Endotracheal Tube ◽  
Bronchial Cuff ◽  
Lateral Decubitus ◽  
Lateral Positioning

Proper bronchial cuff pressure (BCP) is important when using a double-lumen endotracheal tube (DLT), especially in thoracic surgery. As positional change during endotracheal tube placement could alter cuff pressure, we aim to evaluate the change in BCP of DLT from the supine to the lateral decubitus position during thoracic surgery. A total of 69 patients aged 18–70 years who underwent elective lung surgery were recruited. BCP was measured at a series of time points in the supine and lateral decubitus positions after confirming the DLT placement. The primary outcome was change in the initial established BCP (BCPi), which is the maximum pressure at which the BCP did not exceed 40 cmH2O without air leak in the supine position, after lateral decubitus positioning. As the primary outcome, the BCPi increased from 25.4 ± 9.0 cmH2O in the supine position to 29.1 ± 12.2 cmH2O in the lateral decubitus position (p < 0.001). Out of the 69 participants, 43 and 26 patients underwent surgery in the left-lateral decubitus position (LLD group) and the right-lateral decubitus position (RLD group) respectively. In the LLD group, the BCPi increased significantly (p < 0.001) after lateral positioning and the beginning of surgery and the difference value, ∆BCPi, from supine to lateral position was significantly higher in the LLD group than in the RLD group (p = 0.034). Positional change from supine to lateral decubitus could increase the BCPi of DLT and the increase was significantly greater in LLD that in RLD.

scholarly journals BRONCHOSPIROMETRY IN THE LATERAL DECUBITUS POSITION

1950 ◽  
Vol 19 (6) ◽  
pp. 821-829
Author(s):  
Emil Rothstein ◽  
Francis B. Landis ◽  
Benjamin G. Narodick
Keyword(s):  
Lateral Decubitus Position ◽  
Lateral Decubitus

scholarly journals The Cardiac Sympathetic Nerve Activity in the Elderly Is Attenuated in the Right Lateral Decubitus Position

2017 ◽  
Vol 3 ◽  
pp. 233372141770807 ◽  
Author(s):  
Konosuke Sasaki ◽  
Mayu Haga ◽  
Sarina Bao ◽  
Haruka Sato ◽  
Yoshikatsu Saiki ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Lateral Decubitus Position ◽  
The Other ◽  
Elderly Adults ◽  
Nerve Activity ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus ◽  
The Right

Objectives: The aim of this study was to evaluate the effect of the supine, left lateral decubitus, and right lateral decubitus positions on autonomic nervous activity in elderly adults by using spectral analysis of heart rate variability (HRV). Method: Forty-five adults aged 73.6 ± 5.7 years were enrolled. After lying in the supine position, all participants moved to the lateral decubitus positions in a random order and maintained the positions for 10 min, while electrocardiographic data were recorded to measure HRV. Results: The lowest heart rate continued for 10 min when participants were in the left lateral decubitus position compared with the other two positions ( p < .001), while the HRV indexes remained unchanged. The low-frequency HRV to high-frequency HRV ratio (LF/HF) for the right lateral decubitus position was significantly lower than that for the other positions. Discussion: The right lateral decubitus position may attenuate sympathetic nerve activity in elderly adults.

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