Copyright ©The Author(s) 2015.
World J Orthop. Apr 18, 2015; 6(3): 351-359
Published online Apr 18, 2015. doi: 10.5312/wjo.v6.i3.351
Table 2 Strategies for minimizing risk during prone surgical procedures
ComplicationAvoidance strategy
Ophthalmological complications
ION[14]Reverse trendelenburg positioning, colloid administration by anesthesia, limit prolonged intraoperative hypotension
Posterior ION[13]Limit prolonged intraoperative hypotension
Anterior ION[16]None
Central retinal artery occlusion[5,13]Avoid compression of the globe
Cortical blindness[13]Limit prolonged intraoperative hypotension
Neurologic complications
Acute cervical myelopathy[20]Thorough history and preoperative imaging, careful neck positioning during patient transfers and surgical procedure
Brachial plexopathy[21]Careful anatomic positioning of the arm, limiting extension and external rotation of shoulder
Ulnar nerve palsy[30]Avoid compression and pressure at the elbow, maintain arm position during procedure (avoid arm falling off of arm board)
Myocutaneous complications
Compartment syndrome[34-36]Avoid pressure on anterior thigh and leg, avoid extremely long surgical procedures. Extra care with obese patients
Pressure ulcers[37,38]Pad bony prominences. Consider Garner-Wells tongs to eliminate pressure on the face during lengthy procedures
Femoral head avascular necrosis[42]Avoid pressure directly over the groin