The Effect of Blood Pressure Value on Intraoperative Imaging in Biportal Endoscopic Spine Surgery
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: In unilateral biportal endoscopic (UBE) decompression surgery, image quality reduces potential risks in the surgical field and allows the surgical procedure to be performed in a shorter time. This study aimed to investigate the relationship between visualization and blood pressure during surgery and to determine the optimal blood pressure to maintain good visualization during surgery. METHODS: A senior surgeon and an assistant surgeon independently evaluated intraoperative visualization during UBE entry, laminotomy, and foraminotomy. They assessed image quality based on blood pressure readings and each other on a scale of 1 to 4. (Grade 4: clear image; Grade 3: slight bleeding but operable; Grade 2: poor image clarity requiring hemostasis, with no water pressure augmentation or blood pressure therapy needed; Grade 1: unclear image due to significant bleeding, leading to the termination of surgery). During UBE, blood pressure was measured with the cuff on the arm 3 times at 2-minute intervals during the surgical grades, and the patient's systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded. RESULTS: At the UBE entry grade, the cut-off value for SBP was 106.34 and 67.5 for DBP and 83.33 for MAP. In the laminectomy grade, the cut-off value for SBP was 93.83, the cut-off value for DBP was 58.5, and the cut-off value for MAP was 72.33. At the foraminotomy grade, the cut-off value for SBP was 89.17, 55.0 for DBP, and 70.67 for MAP. CONCLUSIONS: Image clarity and patient blood pressure are inter-related during the UBE grades. Surgery keeping SBP below 106 mmHg so as not to pose a risk to the patient provides good image clarity.
Source: World Neurosurgery
Institutions: Ankara University, Ministry of Health
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,943
OpenAlex ID: W4413367025