Postoperative Visual Loss Following Spinal Surgery
Postoperative visual loss (POVL) is a devastating perioperative complication that has received increased attention from anesthesiologists, spine surgeons, and neuro-ophthalmologists over the last 20 years. The most common types of surgical procedures associated with POVL include prone spine surgery, cardiopulmonary bypass procedures, head and neck procedures, and major vascular procedures. The highest reported incidence of symptomatic visual loss is 4.5% in cardiac cases and 0.2% in spine surgery. Concerted efforts from multiple organizations and groups in anesthesiology, neuro-ophthalmology, and surgery have identified risk factors for ischemic optic neuropathy (ION) associated with prone spine surgery, and they developed advisories and recommendations for the prevention of this complication. Recent data from the Nationwide Inpatient Sample indicates that the incidence of ischemic optic neuropathy associated with spine surgery is now decreasing.
KeywordsPostoperative visual loss/perioperative visual loss Ischemic optic neuropathy Central retinal artery occlusion Practice advisory for perioperative visual loss associated with spine surgery American Society of Anesthesiologists Postoperative Visual Loss Registry Elevated venous pressure in the prone position Wilson spine frame Case-control study for ischemic optic neuropathy Risk factors for ischemic optic neuropathy associated with spine surgery Horseshoe headrest
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