Year: 2024
Type: article
Abstract: Prone position is commonly used in spinal surgery as well as other specialties. The associated complications with this are well-documented within the literature [1]. Informed consenting process for prone spinal operations should entail listing the benefits of the proposed surgical procedure as well as the known complications. The commonly quoted complications by the spinal surgeons are infection, CSF leak, bleeding including major vascular injury [2]. Neurological deficit, bladder, bowel and sexual dysfunction, spinal instability, need for revision, stroke, deep vein thrombosis and pulmonary embolism. Less commonly mentioned, although known position-related complications include pressure sores affecting chest wall, breasts, head, neck and face, nerve palsies, abdominal compartment syndrome, lower limb compartment syndrome, cardiovascular compromise and hepatic dysfunction due to prolonged raised central venous pressure and blindness. In particular, blindness although uncommon, is irreversible and it has a devastating long-term functional consequence for the patients. It is therefore of great significance and importance. In addition, failure to include this rare complication in the consent forms could have significant medico-legal ramifications. This letter is a comment on the current practice of consenting patients for prone spinal procedures.
Authors: Balaji Douraiswami, Mohammad Baraka, Ardalan Zolnourian, Ali Nader-Sepahi, Chris Dare
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4396898643