Ischemic optic neuropathy following lumbar spine surgery

1995 ◽  
Vol 83 (2) ◽  
pp. 348-349 ◽  
Author(s):  
Andrew G. LEE
Keyword(s):  
Blood Pressure ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Lumbar Spine Surgery ◽  
Ischemic Optic Neuropathy ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ This 48-year-old hypertensive man, a cigarette smoker, awoke in the recovery room with visual loss in the right eye after uncomplicated lumbar spine surgery. His intraoperative blood pressure had been maintained at relatively low levels to reduce bleeding; a loss of 1500 cc of blood was reported. Postoperative hemoglobin was 4.2 g/dl less than the preoperative hemoglobin; however, the patient did not receive a blood transfusion. A postoperative ophthalmological examination revealed decreased visual acuity, color vision, and visual field in the right eye. The right optic nerve and retina were initially normal but the patient eventually developed optic nerve atrophy consistent with the clinical diagnosis of ischemic optic neuropathy. Neurosurgeons should be aware that this condition may follow uncomplicated lumbar spine surgery and should obtain prompt ophthalmological consultation when patients develop postoperative visual loss. Aggressive and rapid correction of blood pressure and hematocrit may be helpful in individuals who develop ischemic optic neuropathy after lumbar spine surgery.

Minimally invasive retroperitoneal approach for lumbar corpectomy and anterior reconstruction

2000 ◽  
Vol 93 (1) ◽  
pp. 161-167 ◽  
Author(s):  
Manfred Mühlbauer ◽  
Wolfgang Pfisterer ◽  
Richard Eyb ◽  
Engelbert Knosp
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Spinal Fusion ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Content Type ◽  
Anterior Reconstruction ◽  
Fine Print ◽  
Lumbar Corpectomy

✓ The anterior decompressive procedure in which spinal fusion is performed is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgery-related trauma. The purpose of this study was to show that lumbar corpectomy and anterior reconstruction can be performed via a minimally invasive retroperitoneal approach (MIRA) and therefore the surgical approach—related trauma can be reduced. The authors studied retrospectively the hospital records and radiological studies obtained in five patients (mean age 67.4 years, range 59–76 years) who underwent lumbar corpectomy and spinal fusion via an MIRA followed by posterior fixation. Four patients presented with osteoporotic compression fractures at L-2 and L-3, and one patient presented with metastatic disease in L-4 from prostate cancer. Neurological deficits due to cauda equina compression were demonstrated in all patients. The MIRA provided excellent exposure to facilitate complete decompression and anterior reconstruction in all patients, as verified on follow-up radiographic studies. All patients improved clinically. A 1-year follow-up record is available for four patients and a 6-month follow-up record for the fifth patient; continuing clinical improvement has been observed in all. Radiography demonstrated anatomically correct reconstruction in all patients, as well as a solid fusion or a stable compound union in the four patients for whom 1-year follow-up records were available. The MIRA allows the surgeon to perform anterior lumbar spine surgery via a less invasive approach. The efficacy and safety of this technique and its potential to reduce perioperative morbidity compared with conventional retroperitoneal lumbar spine surgery should be further investigated in a larger series.

Ischemic Optic Neuropathy After Lumbar Spine Surgery

1995 ◽  
Vol 15 (4) ◽  
pp. 257
Author(s):  
D M Katz ◽  
J D Trobe ◽  
W T Cornblath ◽  
L B Kline
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Optic Neuropathy ◽  
Lumbar Spine Surgery ◽  
Ischemic Optic Neuropathy

Surgical experiences with giant intracranial aneurysms

1984 ◽  
Vol 61 (6) ◽  
pp. 1009-1028 ◽  
Author(s):  
Lindsay Symon ◽  
Janos Vajda
Keyword(s):  
Blood Pressure ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Intracranial Aneurysms ◽  
Visual Loss ◽  
Considerable Improvement ◽  
Brain Circulation ◽  
Content Type ◽  
Space Occupying Lesion ◽  
Fine Print

✓ A series of 35 patients with 36 giant aneurysms is presented. Thirteen patients presented following subarachnoid hemorrhage (SAH) and 22 with evidence of a space-occupying lesion without recent SAH. The preferred technique of temporary trapping of the aneurysm, evacuation of the contained thrombus, and occlusion of the neck by a suitable clip is described. The danger of attempted ligation in atheromatous vessels is stressed. Intraoperatively, blood pressure was adjusted to keep the general brain circulation within autoregulatory limits. Direct occlusion of the aneurysm was possible in over 80% of the cases. The mortality rate was 8% in 36 operations. Six percent of patients had a poor result. Considerable improvement in visual loss was evident in six of seven patients in whom this was a presenting feature, and in four of seven with disturbed eye movements.

Postoperative Visual Loss Following Lumbar Spine Surgery: A Review of Risk Factors by Diagnosis

2015 ◽  
Vol 84 (6) ◽  
pp. 2010-2021 ◽  
Author(s):  
Amy Li ◽  
Christian Swinney ◽  
Anand Veeravagu ◽  
Inderpreet Bhatti ◽  
John Ratliff
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Visual Loss ◽  
Lumbar Spine Surgery ◽  
Postoperative Visual Loss

“A COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF IN POSTOPERAT ETORICOXIB IN PAIN RELIEF IN PATIENTS IN UNDERGOING LUMBAR SPINE SURGERY ”

2021 ◽  
pp. 65-66
Author(s):  
Deepti chauhan ◽  
Ashish Mathur ◽  
Sukhnandan Singh Tomar ◽  
Heena sheikh
Keyword(s):  
Blood Pressure ◽  
Lumbar Spine ◽  
Pain Relief ◽  
General Anaesthesia ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Analgesic Requirement ◽  
Placebo Tablet ◽  
Respiratory Parameters ◽  
Different Doses

AIMS AND OBJECTIVES: To evaluate the efcacy of Etoricoxib in different doses in postoperative pain relief in patients undergoing lumbar spine surgery. MATERIALAND METHOD : 80 patients of ASA grade І & ІІ of either sex scheduled for lumbar spine surgery under general anaesthesia were divided into 2 groups (n=40 each) randomly.Group E (n=40) Patients who received a 90 mg Etoricoxib 1 hour before surgery and another tablet the following morning. Group 'P'(n=40) Patients who received a placebo tablet 1 hour before surgery and again the following morning. Pulse rate, blood pressure, respiratory rate and severity of pain on NRS scale was noted at 0 hr, 4 hr, 8 hr, 12 hr, 16 hr, 20 hr, 24 hr, 28 hr, 32 hr and 48 hr after surgery. And the presence or absence of adverse effects, such as headache, nausea, vomiting, dizziness, and drowsiness were noted. RESULT:Analysis revealed that time for rst analgesic requirement was signicantly longer with oral Etoricoxib 90 mg than with placebo. Pre-emptive oral Etoricoxib 90 mg decreases the severity of pain postoperatively but not signicantly as compared to placebo in patients posted for lumbar spine surgery under general anaesthesia. Oral Etoricoxib 90 mg had no signicant effect on cardiovascular and respiratory parameters. Patients receiving Etoricoxib had higher incidence of nausea, vomiting. CONCLUSION: that time for rst analgesic requirement was signicantly longer with oral Etoricoxib than placebo.

Use of intrathecal morphine for postoperative pain relief following lumbar spine surgery

1985 ◽  
Vol 63 (3) ◽  
pp. 413-416 ◽  
Author(s):  
Padraic O'Neill ◽  
Christine Knickenberg ◽  
Senarath Bogahalanda ◽  
Anthony E. Booth
Keyword(s):  
Lumbar Spine ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Spine Surgery ◽  
Intrathecal Morphine ◽  
Postoperative Pain Relief ◽  
Lumbar Spine Surgery ◽  
Double Blind ◽  
Content Type ◽  
The Mean

✓ A randomized prospective double-blind trial of intrathecal morphine for postoperative pain relief following lumbar spine surgery is described. Intrathecal morphine significantly reduced the mean pain score in the postoperative period (p < 0.01) and there was a corresponding significant reduction in the need for additional postoperative analgesia (p < 0.05). The possible mechanism of action of intrathecal morphine and the potential advantages of this technique are discussed. Possible side effects are also considered, and caution is urged until wider experience has been obtained.

An experimental cerebral missile injury model in primates

1977 ◽  
Vol 46 (6) ◽  
pp. 776-783 ◽  
Author(s):  
H. Alan Crockard ◽  
Frederick D. Brown ◽  
Lydia M. Johns ◽  
Sean Mullan
Keyword(s):  
Blood Pressure ◽  
Rhesus Monkeys ◽  
High Energy ◽  
Content Type ◽  
Missile Injury ◽  
Injury Model ◽  
Bone Fragments ◽  
Stem Damage ◽  
The Right ◽  
Fine Print

✓ An experimental model of cerebral missile injury in rhesus monkeys is described. The main objective was to create a “clean” wound devoid of bleeding from major vessels and complications due to bone fragments. There was a correlation between the wounding energy and the physiological signs, although we underestimated the actual energy level. After the right parietooccipital to right frontal injury, there was bradycardia, changes in blood pressure, and, in high-energy wounds, a marked alteration in respiration. This suggests that the missile's energy produces direct brain-stem damage, the extent of which can be related to the wounding energy.

The American Society of Anesthesiologists Postoperative Visual Loss Registry

2006 ◽  
Vol 105 (4) ◽  
pp. 652-659 ◽  
Author(s):  
Lorri A. Lee ◽  
Steven Roth ◽  
Karen L. Posner ◽  
Frederick W. Cheney ◽  
Robert A. Caplan ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spine Surgery ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Ischemic Optic Neuropathy ◽  
Bilateral Disease ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Postoperative Visual Loss

Background Postoperative visual loss after prone spine surgery is increasingly reported in association with ischemic optic neuropathy, but its etiology is unknown. Methods To describe the clinical characteristics of these patients, the authors analyzed a retrospectively collected series of 93 spine surgery cases voluntarily submitted to the American Society of Anesthesiologists Postoperative Visual Loss Registry on standardized data forms. Results Ischemic optic neuropathy was associated with 83 of 93 spine surgery cases. The mean age of the patients was 50 +/- 14 yr, and most patients were relatively healthy. Mayfield pins supported the head in 16 of 83 cases. The mean anesthetic duration was 9.8 +/- 3.1 h, and the median estimated blood loss was 2.0 l (range, 0.1-25 l). Bilateral disease was present in 55 patients, with complete visual loss in the affected eye(s) in 47. Ischemic optic neuropathy cases had significantly higher anesthetic duration, blood loss, percentage of patients in Mayfield pins, and percentage of patients with bilateral disease compared with the remaining 10 cases of visual loss diagnosed with central retinal artery occlusion (P &lt; 0.05), suggesting they are of different etiology. Conclusions Ischemic optic neuropathy was the most common cause of visual loss after spine surgery in the Registry, and most patients were relatively healthy. Blood loss of 1,000 ml or greater or anesthetic duration of 6 h or longer was present in 96% of these cases. For patients undergoing lengthy spine surgery in the prone position, the risk of visual loss should be considered in the preoperative discussion with patients.

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