Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.38
Peer-review started: August 20, 2019
First decision: September 9, 2019
Revised: October 15, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: January 6, 2020
Total cervical artificial disc replacement (TDR) has been considered a safe and effective alternative surgical treatment for cervical spondylosis and degenerative disc disease that have failed to improve with conservative methods.
Positioning the surgical patient is a critical part of the procedure. Appropriate patient positioning is crucial not only for the safety of the patient but also for optimizing surgical exposure, ensuring adequate and safe anesthesia, and allowing the surgeon to operate comfortably during lengthy procedures. The surgical posture is the traditional position used in anterior cervical approach; in general, patients are in a supine position with a pad under their shoulders and a ring-shaped pillow under their head. The activity of the adjacent segment accelerates the degeneration of the adjacent layers and causes new symptoms.
To investigate the clinical outcomes of the use of a modified surgical position versus the traditional surgical position in anterior approach for TDR.
In the modified position group, patients had a soft pillow under their neck, and their jaw and both shoulders were fixed with wide tape. The analyzed data included intraoperative blood loss, position setting time, total operation time, and perioperative blood pressure and heart rate.
Blood pressure and heart rate were not significantly different before and after body positioning in both groups. Compared with the traditional position group, the modified position group showed a statistically significantly longer position setting time. However, the total operation time and intraoperative blood loss were significantly reduced in the modified position group compared with the traditional position group.
The clinical outcomes indicated that total operation time and intraoperative blood loss were lower in the modified position group than in the traditional position group, thus reducing the risks of surgery while increasing the position setting time.
The modified surgical position is a safe and effective method to be used in anterior approach for TDR surgery.