Case ReportIschemic Orbital Compartment Syndrome as a Complication of Spinal Surgery in the Prone Position
Section snippets
Case Report
An 80-year-old man, with no significant systemic or ocular diseases, underwent an 8-hour L3–L5 decompression laminectomy for lumbar spinal stenosis, under general anesthesia in the prone position. Intraoperatively, his head was supported on a silicone head rest (Fig 1). On extubation, some facial and periorbital swelling was noted. Several hours later, the patient complained of significant left periocular pain and reduced vision. Examination revealed facial edema with 4 mm of left proptosis and
Discussion
In performing spinal surgery on a patient who is placed in the prone position, the patient’s face is supported by a soft headrest device that is designed to secure the head while minimizing pressure on facial structures, especially the globes. It is estimated that the incidence of visual disturbances and blindness after anesthesia for these major surgical procedures varies between 0.05% and 1%.3 Stevens et al4 reviewed the ophthalmic complications in 3450 patients who underwent spinal surgeries
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Cited by (53)
A case of Perioperative Visual Loss Following Spine Surgery: Can NIRS monitoring give us a clue?
2024, Medical Journal Armed Forces IndiaSuccess rates of lateral canthotomy and cantholysis for treatment of orbital compartment syndrome
2023, American Journal of Emergency MedicineThe Enigma of Orbital Compartment Syndrome After Lumbar Spine Surgery in the Prone Position: Case Report and Literature Review
2018, World NeurosurgeryCitation Excerpt :To the best of our knowledge, only 3 other patients affected by OCS were reported in the literature after lumbar spine surgeries (Table 1).9-11 Symptoms were mostly recognized a few hours after surgery9-11 except in the present case, in which hyperemia of the eyelids was noted before the patient awoke. Although management of ION and CRAO is generally conservative and supportive by trying to restore ocular perfusion, OCS is an ophthalmologic emergency and should be promptly decompressed with canthotomy and cantholysis even before further imaging to minimize visual loss.13,24
Post operative visual loss after cervical laminectomy in prone position
2017, Brazilian Journal of AnesthesiologyPositioning in Neurosurgery
2017, Essentials of Neuroanesthesia
Manuscript no. 2005-348.
The authors state that no conflicting relationships exist, and that no financial support was obtained for the article.